How much rates vary
Facilitymedian $245 · 10th to 90th $95 to $457Professionalmedian $148 · 10th to 90th $135 to $339
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 $147.91 Median $151.36 Typical High $245.47 | Facility | None | $147.91 | $151.36 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $223.87 | Professional | None | $147.91 | $162.18 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $457.09 | Professional | None | $251.19 | $457.09 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $158.49 Median $245.47 Typical High $489.78 | Facility | None | $158.49 | $245.47 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $257.04 | Professional | None | $134.90 | $134.90 | $257.04 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $208.93 Typical High $457.09 | Facility | None | $75.86 | $208.93 | $457.09 |
Blue Shield Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $204.17 | Professional | None | $162.18 | $162.18 | $204.17 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | None | $147.91 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $275.42 Typical High $371.54 | Facility | None | $147.91 | $275.42 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Contra Costa Health Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $165.96 | Professional | None | $107.15 | $117.49 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $302.00 | Professional | None | $128.82 | $141.25 | $302.00 |
Lucent Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Providence Setting Facility Modifier None Typical Low $147.91 Median $281.84 Typical High $426.58 | Facility | None | $147.91 | $281.84 | $426.58 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Sutter Health Plus Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $1,096.48 | Facility | None | $147.91 | $147.91 | $1,096.48 |
United Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $165.96 | Professional | None | $134.90 | $134.90 | $165.96 |
6 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 $74.13 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $74.13 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $29.51 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.79 | $15.14 | $15.14 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | JZ · No drug discarded | $123.03 | $123.03 | $123.03 |
HealthNet Setting Professional Modifier JZ · No drug discarded Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | JZ · No drug discarded | $416.87 | $416.87 | $416.87 |
Where California sits
The same service costs 2.4 times more in Wyoming than in New York. 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· 27th of 51
$148
WY $355NY $148
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.