How much rates vary
Facilitymedian $16 · 10th to 90th $9 to $27Professionalmedian $9 · 10th to 90th $9 to $10
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 $8.71 Median $13.49 Typical High $22.91 | Facility | None | $8.71 | $13.49 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.33 Median $14.45 Typical High $29.51 | Facility | None | $9.33 | $14.45 | $29.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $15.14 | Professional | None | $8.91 | $8.91 | $15.14 |
Blue Shield Setting Facility Modifier None Typical Low $11.48 Median $16.22 Typical High $23.44 | Facility | None | $11.48 | $16.22 | $23.44 |
Blue Shield Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $10.96 | Professional | None | $8.71 | $8.71 | $10.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $8.71 Median $9.55 Typical High $9.55 | Professional | None | $8.71 | $9.55 | $9.55 |
Cigna Setting Facility Modifier None Typical Low $8.71 Median $15.85 Typical High $21.88 | Facility | None | $8.71 | $15.85 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Contra Costa Health Setting Professional Modifier None Typical Low $7.24 Median $7.94 Typical High $8.71 | Professional | None | $7.24 | $7.94 | $8.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.76 Median $8.71 Typical High $19.05 | Professional | None | $7.76 | $8.71 | $19.05 |
Lucent Health Setting Professional Modifier None Typical Low $9.12 Median $10.23 Typical High $16.22 | Professional | None | $9.12 | $10.23 | $16.22 |
Molina Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
Providence Setting Facility Modifier None Typical Low $8.71 Median $15.49 Typical High $23.99 | Facility | None | $8.71 | $15.49 | $23.99 |
Providence Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Sutter Health Plus Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
United Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $28.84 | Facility | None | $8.71 | $8.71 | $28.84 |
United Setting Professional Modifier None Typical Low $7.24 Median $8.71 Typical High $10.47 | Professional | None | $7.24 | $8.71 | $10.47 |
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 $4.37 Median $6.76 Typical High $11.22 | Facility | 52 · Reduced service | $4.37 | $6.76 | $11.22 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.74 Median $2.69 Typical High $4.57 | Facility | 53 · Discontinued | $1.74 | $2.69 | $4.57 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.29 Median $2.00 Typical High $3.39 | Facility | 55 · Aftercare only | $1.29 | $2.00 | $3.39 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.87 Median $1.35 Typical High $2.24 | Facility | 56 · Pre-op care only | $0.87 | $1.35 | $2.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 52 · Reduced service | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 53 · Discontinued | $1.74 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.32 Typical High $1.32 | Professional | 55 · Aftercare only | $1.29 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.87 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.87 | $0.87 | $0.87 |
Where California sits
The same service costs 1.9 times more in Wyoming than in Mississippi. 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· 26th of 51
$8.71
WY $16.22MS $8.71
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.