How much rates vary
Facilitymedian $214 · 10th to 90th $145 to $3,467Professionalmedian $151 · 10th to 90th $95 to $9,120
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 $2,754.23 Median $2,754.23 Typical High $2,818.38 | Facility | None | $2,754.23 | $2,754.23 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,754.23 | $2,818.38 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $3,467.37 Typical High $14,454.40 | Facility | None | $2,754.23 | $3,467.37 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $5,248.07 | Professional | None | $2,754.23 | $2,754.23 | $5,248.07 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $234.42 | Facility | None | $95.50 | $100.00 | $234.42 |
Blue Shield Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $125.89 | Professional | None | $67.61 | $95.50 | $125.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $204.17 | Professional | None | $93.33 | $93.33 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $190.55 Typical High $302.00 | Facility | None | $141.25 | $190.55 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $93.33 Median $2,754.23 Typical High $3,311.31 | Professional | None | $93.33 | $2,754.23 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $331.13 | Professional | None | $134.90 | $165.96 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $11,748.98 | Professional | None | $9,120.11 | $9,120.11 | $11,748.98 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $102.33 | Professional | None | $93.33 | $93.33 | $102.33 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $190.55 Typical High $380.19 | Facility | None | $141.25 | $190.55 | $380.19 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
United Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $177.83 | Professional | None | $125.89 | $125.89 | $177.83 |
4 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 Professional Modifier 52 · Reduced service Typical Low $1,380.38 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,380.38 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $416.87 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $275.42 | $281.84 | $281.84 |
Where California sits
The same service costs 37.2 times more in Wyoming than in North Carolina. 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· 25th of 51
$162
WY $3,548NC $95.50
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.