How much rates vary
Facilitymedian $10 · 10th to 90th $5 to $19Professionalmedian $5 · 10th to 90th $5 to $8
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 $5.25 Median $6.61 Typical High $12.59 | Facility | None | $5.25 | $6.61 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.62 Typical High $7.94 | Professional | None | $5.25 | $5.62 | $7.94 |
Ambetter Setting Professional Modifier None Typical Low $4.90 Median $9.12 Typical High $9.55 | Professional | None | $4.90 | $9.12 | $9.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.37 Median $7.24 Typical High $17.78 | Facility | None | $5.37 | $7.24 | $17.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.75 | Professional | None | $5.13 | $5.13 | $5.75 |
Blue Shield Setting Facility Modifier None Typical Low $7.41 Median $16.60 Typical High $19.50 | Facility | None | $7.41 | $16.60 | $19.50 |
Blue Shield Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.46 | Professional | None | $5.25 | $5.25 | $6.46 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $5.25 Median $5.75 Typical High $5.75 | Professional | None | $5.25 | $5.75 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $5.25 Median $9.55 Typical High $13.18 | Facility | None | $5.25 | $9.55 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $6.76 Median $7.41 Typical High $10.23 | Professional | None | $6.76 | $7.41 | $10.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.68 Median $4.90 Typical High $8.91 | Professional | None | $4.68 | $4.90 | $8.91 |
Lucent Health Setting Professional Modifier None Typical Low $7.94 Median $17.78 Typical High $52.48 | Professional | None | $7.94 | $17.78 | $52.48 |
Molina Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | None | $6.61 | $6.61 | $6.61 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Providence Setting Facility Modifier None Typical Low $5.25 Median $9.55 Typical High $14.79 | Facility | None | $5.25 | $9.55 | $14.79 |
Providence Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
United Setting Professional Modifier None Typical Low $4.90 Median $5.25 Typical High $8.51 | Professional | None | $4.90 | $5.25 | $8.51 |
8 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 $2.63 Median $3.89 Typical High $6.46 | Facility | 52 · Reduced service | $2.63 | $3.89 | $6.46 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.07 Median $1.55 Typical High $2.57 | Facility | 53 · Discontinued | $1.07 | $1.55 | $2.57 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.79 Median $1.15 Typical High $1.95 | Facility | 55 · Aftercare only | $0.79 | $1.15 | $1.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.78 Typical High $1.29 | Facility | 56 · Pre-op care only | $0.52 | $0.78 | $1.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.63 Median $2.69 Typical High $2.69 | Professional | 52 · Reduced service | $2.63 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 53 · Discontinued | $1.07 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.52 |
Where California sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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· 29th of 51
$5.25
WY $10.00CO $5.25
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.