How much rates vary
Facilitymedian $724 · 10th to 90th $79 to $6,918Professionalmedian $148 · 10th to 90th $79 to $724
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 $87.10 Median $398.11 Typical High $501.19 | Professional | None | $87.10 | $398.11 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,897.79 Typical High $10,000.00 | Facility | None | $2,511.89 | $4,897.79 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $158.49 Typical High $281.84 | Professional | None | $95.50 | $158.49 | $281.84 |
Blue Shield Setting Facility Modifier None Typical Low $147.91 Median $354.81 Typical High $602.56 | Facility | None | $147.91 | $354.81 | $602.56 |
Blue Shield Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $169.82 | Professional | None | $81.28 | $114.82 | $169.82 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $57.54 Median $70.79 Typical High $141.25 | Professional | None | $57.54 | $70.79 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $1,258.93 | Facility | None | $66.07 | $104.71 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $489.78 | Professional | None | $125.89 | $158.49 | $489.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $138.04 | Professional | None | $63.10 | $85.11 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $57.54 Median $107.15 Typical High $194.98 | Professional | None | $57.54 | $107.15 | $194.98 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $851.14 | Professional | None | $724.44 | $851.14 | $851.14 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $109.65 Typical High $1,122.02 | Facility | None | $66.07 | $109.65 | $1,122.02 |
Providence Setting Professional Modifier None Typical Low $57.54 Median $165.96 Typical High $269.15 | Professional | None | $57.54 | $165.96 | $269.15 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $53.70 Median $87.10 Typical High $181.97 | Professional | None | $53.70 | $87.10 | $181.97 |
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 $51.29 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $51.29 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $20.42 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $75.86 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $15.14 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $10.23 | $39.81 | $39.81 |
Where California sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 4th of 51
$158
AK $263VA $77.62
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.