How much rates vary
Facilitymedian $95 · 10th to 90th $62 to $174Professionalmedian $62 · 10th to 90th $56 to $240
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 $60.26 Median $70.79 Typical High $141.25 | Facility | None | $60.26 | $70.79 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $91.20 | Professional | None | $60.26 | $66.07 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $199.53 | Facility | None | $66.07 | $100.00 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $87.10 | Professional | None | $56.23 | $56.23 | $87.10 |
Blue Shield Setting Facility Modifier None Typical Low $70.79 Median $93.33 Typical High $165.96 | Facility | None | $70.79 | $93.33 | $165.96 |
Blue Shield Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $81.28 | Professional | None | $66.07 | $66.07 | $81.28 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | None | $60.26 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $107.15 Typical High $151.36 | Facility | None | $60.26 | $107.15 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $47.86 Median $51.29 Typical High $61.66 | Professional | None | $47.86 | $51.29 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $57.54 Typical High $107.15 | Professional | None | $53.70 | $57.54 | $107.15 |
Lucent Health Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $257.04 | Professional | None | $239.88 | $257.04 | $257.04 |
Providence Setting Facility Modifier None Typical Low $60.26 Median $109.65 Typical High $165.96 | Facility | None | $60.26 | $109.65 | $165.96 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Sutter Health Plus Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $275.42 | Facility | None | $60.26 | $60.26 | $275.42 |
United Setting Professional Modifier None Typical Low $24.55 Median $56.23 Typical High $67.61 | Professional | None | $24.55 | $56.23 | $67.61 |
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 $30.20 Median $30.90 Typical High $70.79 | Facility | 52 · Reduced service | $30.20 | $30.90 | $70.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.02 Median $12.30 Typical High $28.18 | Facility | 53 · Discontinued | $12.02 | $12.30 | $28.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $21.38 | Facility | 55 · Aftercare only | $9.12 | $9.12 | $21.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.17 Typical High $14.13 | Facility | 56 · Pre-op care only | $6.03 | $6.17 | $14.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $30.20 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $12.02 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.03 | $6.17 | $6.17 |
Where California sits
The same service costs 2.0 times more in Wyoming than in Hawaii. 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· 8th of 51
$61.66
WY $83.18HI $41.69
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.