How much rates vary
Facilitymedian $219 · 10th to 90th $89 to $407Professionalmedian $135 · 10th to 90th $120 to $355
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 $131.83 Median $134.90 Typical High $218.78 | Facility | None | $131.83 | $134.90 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $141.25 Typical High $181.97 | Professional | None | $131.83 | $141.25 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $218.78 Typical High $436.52 | Facility | None | $138.04 | $218.78 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $354.81 | Professional | None | $120.23 | $128.82 | $354.81 |
Blue Shield Setting Facility Modifier None Typical Low $72.44 Median $186.21 Typical High $436.52 | Facility | None | $72.44 | $186.21 | $436.52 |
Blue Shield Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $398.11 | Professional | None | $131.83 | $154.88 | $398.11 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $120.23 Median $144.54 Typical High $199.53 | Professional | None | $120.23 | $144.54 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $234.42 Typical High $331.13 | Facility | None | $131.83 | $234.42 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $380.19 | Professional | None | $120.23 | $147.91 | $380.19 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $239.88 Typical High $371.54 | Facility | None | $131.83 | $239.88 | $371.54 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | None | $131.83 | $131.83 | $134.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $1,148.15 | Facility | None | $131.83 | $131.83 | $1,148.15 |
United Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $741.31 | Professional | None | $120.23 | $125.89 | $741.31 |
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 $66.07 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $26.30 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $13.18 | $13.49 | $13.49 |
Where California sits
The same service costs 8.7 times more in Texas than in Kansas. 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· 7th of 51
$151
TX $355KS $40.74
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.