How much rates vary
Facilitymedian $50 · 10th to 90th $26 to $91Professionalmedian $30 · 10th to 90th $21 to $126
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 $20.89 Median $31.62 Typical High $75.86 | Facility | None | $20.89 | $31.62 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $31.62 | Professional | None | $20.89 | $21.38 | $31.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.18 Median $42.66 Typical High $95.50 | Facility | None | $28.18 | $42.66 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $56.23 | Professional | None | $29.51 | $29.51 | $56.23 |
Blue Shield Setting Facility Modifier None Typical Low $29.51 Median $87.10 Typical High $100.00 | Facility | None | $29.51 | $87.10 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $27.54 | Professional | None | $20.89 | $20.89 | $27.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $20.89 Median $22.91 Typical High $22.91 | Professional | None | $20.89 | $22.91 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $38.02 Typical High $52.48 | Facility | None | $20.89 | $38.02 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $19.05 Median $20.89 Typical High $27.54 | Professional | None | $19.05 | $20.89 | $27.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.89 Median $29.51 Typical High $56.23 | Professional | None | $20.89 | $29.51 | $56.23 |
Lucent Health Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Providence Setting Facility Modifier None Typical Low $21.38 Median $39.81 Typical High $58.88 | Facility | None | $21.38 | $39.81 | $58.88 |
Providence Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $27.54 Median $30.90 Typical High $41.69 | Professional | None | $27.54 | $30.90 | $41.69 |
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 $10.47 Median $15.85 Typical High $38.02 | Facility | 52 · Reduced service | $10.47 | $15.85 | $38.02 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.17 Median $6.31 Typical High $15.14 | Facility | 53 · Discontinued | $4.17 | $6.31 | $15.14 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.16 Median $4.79 Typical High $11.22 | Facility | 55 · Aftercare only | $3.16 | $4.79 | $11.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.09 Median $3.16 Typical High $7.59 | Facility | 56 · Pre-op care only | $2.09 | $3.16 | $7.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $10.72 Typical High $10.72 | Professional | 52 · Reduced service | $10.47 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $4.17 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.09 | $2.14 | $2.14 |
Where California sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 9th of 51
$29.51
WY $79.43KY $20.89
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.