How much rates vary
Facilitymedian $3,236 · 10th to 90th $851 to $11,220Professionalmedian $275 · 10th to 90th $120 to $2,188
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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $1,778.28 | Professional | None | $316.23 | $316.23 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $5,248.07 Typical High $10,471.29 | Facility | None | $2,511.89 | $5,248.07 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $263.03 Typical High $363.08 | Professional | None | $72.44 | $263.03 | $363.08 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $3,981.07 Typical High $9,549.93 | Facility | None | $69.18 | $3,981.07 | $9,549.93 |
Blue Shield Setting Professional Modifier None Typical Low $85.11 Median $190.55 Typical High $398.11 | Professional | None | $85.11 | $190.55 | $398.11 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $346.74 | Professional | None | $120.23 | $147.91 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,290.87 Typical High $4,677.35 | Facility | None | $758.58 | $2,290.87 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $316.23 | Professional | None | $251.19 | $251.19 | $316.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $257.04 Typical High $407.38 | Professional | None | $120.23 | $257.04 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,778.28 | $2,187.76 | $2,187.76 |
Providence Setting Facility Modifier None Typical Low $512.86 Median $2,238.72 Typical High $4,570.88 | Facility | None | $512.86 | $2,238.72 | $4,570.88 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $426.58 | Professional | None | $117.49 | $125.89 | $426.58 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,370.32 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,370.32 | $17,378.01 |
United Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $812.83 | Professional | None | $158.49 | $229.09 | $812.83 |
5 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 $158.49 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $31.62 |
Where California sits
The same service costs 19.5 times more in Texas 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· 21st of 51
$407
TX $1,778NY $91.20
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.