How much rates vary
Facilitymedian $35 · 10th to 90th $20 to $83Professionalmedian $20 · 10th to 90th $19 to $29
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 $18.62 Median $21.38 Typical High $51.29 | Facility | None | $18.62 | $21.38 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $27.54 | Professional | None | $18.62 | $18.62 | $27.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $21.38 Median $33.88 Typical High $69.18 | Facility | None | $21.38 | $33.88 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $38.02 | Professional | None | $20.42 | $20.42 | $38.02 |
Blue Shield Setting Facility Modifier None Typical Low $26.30 Median $72.44 Typical High $95.50 | Facility | None | $26.30 | $72.44 | $95.50 |
Blue Shield Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $23.44 | Professional | None | $18.62 | $18.62 | $23.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $18.62 Median $20.42 Typical High $20.42 | Professional | None | $18.62 | $20.42 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $25.70 Typical High $46.77 | Facility | None | $18.62 | $25.70 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Contra Costa Health Setting Professional Modifier None Typical Low $20.89 Median $26.30 Typical High $28.84 | Professional | None | $20.89 | $26.30 | $28.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $18.20 Median $20.42 Typical High $41.69 | Professional | None | $18.20 | $20.42 | $41.69 |
Lucent Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $72.44 | Professional | None | $34.67 | $34.67 | $72.44 |
Providence Setting Facility Modifier None Typical Low $18.62 Median $26.92 Typical High $51.29 | Facility | None | $18.62 | $26.92 | $51.29 |
Providence Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
United Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
United Setting Professional Modifier None Typical Low $20.42 Median $21.38 Typical High $41.69 | Professional | None | $20.42 | $21.38 | $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 $9.33 Median $10.72 Typical High $25.70 | Facility | 52 · Reduced service | $9.33 | $10.72 | $25.70 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.72 Median $4.37 Typical High $10.23 | Facility | 53 · Discontinued | $3.72 | $4.37 | $10.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.75 Median $3.24 Typical High $7.76 | Facility | 55 · Aftercare only | $2.75 | $3.24 | $7.76 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.14 Typical High $5.13 | Facility | 56 · Pre-op care only | $1.86 | $2.14 | $5.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.82 Typical High $2.82 | Professional | 55 · Aftercare only | $2.75 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $1.86 |
Where California sits
The same service costs 1.8 times more in Hawaii than in Ohio. 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· 14th of 51
$20.42
HI $33.11OH $18.62
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.