How much rates vary
Facilitymedian $47 · 10th to 90th $26 to $83Professionalmedian $25 · 10th to 90th $24 to $60
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 $24.55 Median $28.84 Typical High $60.26 | Facility | None | $24.55 | $28.84 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $25.70 Typical High $37.15 | Professional | None | $24.55 | $25.70 | $37.15 |
Ambetter Setting Professional Modifier None Typical Low $24.55 Median $38.02 Typical High $47.86 | Professional | None | $24.55 | $38.02 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.92 Median $40.74 Typical High $85.11 | Facility | None | $26.92 | $40.74 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $44.67 | Professional | None | $23.99 | $23.99 | $44.67 |
Blue Shield Setting Facility Modifier None Typical Low $34.67 Median $70.79 Typical High $100.00 | Facility | None | $34.67 | $70.79 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $33.88 | Professional | None | $26.92 | $26.92 | $33.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $24.55 Median $26.92 Typical High $26.92 | Professional | None | $24.55 | $26.92 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $38.02 Typical High $61.66 | Facility | None | $24.55 | $38.02 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Contra Costa Health Setting Professional Modifier None Typical Low $23.99 Median $27.54 Typical High $30.90 | Professional | None | $23.99 | $27.54 | $30.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.88 Median $24.55 Typical High $44.67 | Professional | None | $21.88 | $24.55 | $44.67 |
Lucent Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Providence Setting Facility Modifier None Typical Low $24.55 Median $38.02 Typical High $67.61 | Facility | None | $24.55 | $38.02 | $67.61 |
Providence Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Sutter Health Plus Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
United Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $213.80 | Facility | None | $24.55 | $24.55 | $213.80 |
United Setting Professional Modifier None Typical Low $23.99 Median $25.12 Typical High $28.84 | Professional | None | $23.99 | $25.12 | $28.84 |
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 $12.30 Median $12.59 Typical High $30.20 | Facility | 52 · Reduced service | $12.30 | $12.59 | $30.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.90 Median $5.01 Typical High $12.02 | Facility | 53 · Discontinued | $4.90 | $5.01 | $12.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.72 Median $3.80 Typical High $8.91 | Facility | 55 · Aftercare only | $3.72 | $3.80 | $8.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.51 Typical High $6.03 | Facility | 56 · Pre-op care only | $2.45 | $2.51 | $6.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $4.90 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
Where California sits
The same service costs 2.8 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· 21st of 51
$24.55
WY $61.66NC $22.39
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.