How much rates vary
Facilitymedian $9 · 10th to 90th $5 to $26Professionalmedian $5 · 10th to 90th $4 to $7
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $4.27 Median $7.76 Typical High $13.18 | Facility | None | $4.27 | $7.76 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.37 Typical High $8.51 | Professional | None | $4.27 | $4.37 | $8.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.68 Median $5.62 Typical High $6.31 | Facility | None | $4.68 | $5.62 | $6.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $7.41 | Professional | None | $5.13 | $5.13 | $7.41 |
Blue Shield Setting Facility Modifier None Typical Low $6.03 Median $21.88 Typical High $28.84 | Facility | None | $6.03 | $21.88 | $28.84 |
Blue Shield Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.25 | Professional | None | $4.27 | $4.27 | $5.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $4.27 Median $4.68 Typical High $4.68 | Professional | None | $4.27 | $4.68 | $4.68 |
Cigna Setting Facility Modifier None Typical Low $4.27 Median $7.94 Typical High $10.72 | Facility | None | $4.27 | $7.94 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Contra Costa Health Setting Professional Modifier None Typical Low $5.50 Median $7.76 Typical High $8.51 | Professional | None | $5.50 | $7.76 | $8.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.27 Median $5.01 Typical High $8.71 | Professional | None | $4.27 | $5.01 | $8.71 |
Lucent Health Setting Professional Modifier None Typical Low $2.24 Median $14.45 Typical High $21.88 | Professional | None | $2.24 | $14.45 | $21.88 |
Molina Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
Providence Setting Facility Modifier None Typical Low $4.37 Median $8.13 Typical High $12.88 | Facility | None | $4.37 | $8.13 | $12.88 |
Providence Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | None | $12.59 | $12.59 | $12.59 |
United Setting Professional Modifier None Typical Low $5.01 Median $5.25 Typical High $7.41 | Professional | None | $5.01 | $5.25 | $7.41 |
9 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $2.14 Median $3.89 Typical High $6.61 | Facility | 52 · Reduced service | $2.14 | $3.89 | $6.61 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.85 Median $1.55 Typical High $2.63 | Facility | 53 · Discontinued | $0.85 | $1.55 | $2.63 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.65 Median $1.15 Typical High $1.95 | Facility | 55 · Aftercare only | $0.65 | $1.15 | $1.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.78 Typical High $1.32 | Facility | 56 · Pre-op care only | $0.43 | $0.78 | $1.32 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.14 Median $2.19 Typical High $2.19 | Professional | 52 · Reduced service | $2.14 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.87 Typical High $0.87 | Professional | 53 · Discontinued | $0.85 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.43 | $0.43 | $0.43 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | JZ · No drug discarded | $5.01 | $5.01 | $5.01 |
Where California sits
The same service costs 5.1 times more in Wyoming than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
California· 20th of 51
$5.01
WY $21.88AL $4.27
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.