How much rates vary
Facilitymedian $4,571 · 10th to 90th $676 to $12,303Professionalmedian $832 · 10th to 90th $288 to $6,918
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 $2,238.72 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,238.72 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $794.33 | Professional | None | $676.08 | $676.08 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $6,918.31 Typical High $13,489.63 | Facility | None | $3,630.78 | $6,918.31 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $831.76 Typical High $1,445.44 | Professional | None | $794.33 | $831.76 | $1,445.44 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $891.25 Typical High $4,786.30 | Facility | None | $97.72 | $891.25 | $4,786.30 |
Blue Shield Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $371.54 | Professional | None | $204.17 | $288.40 | $371.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,071.52 | Professional | None | $891.25 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,623.41 Typical High $10,000.00 | Facility | None | $758.58 | $5,623.41 | $10,000.00 |
Contra Costa Health Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,754.40 | Professional | None | $5,495.41 | $5,495.41 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,621.81 | Professional | None | $758.58 | $891.25 | $1,621.81 |
Lucent Health Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,918.31 | Professional | None | $5,623.41 | $5,623.41 | $6,918.31 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $5,623.41 Typical High $9,772.37 | Facility | None | $758.58 | $5,623.41 | $9,772.37 |
Providence Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $1,412.54 | Professional | None | $831.76 | $891.25 | $1,412.54 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,754.40 | $17,378.01 |
United Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,348.96 | Professional | None | $575.44 | $724.44 | $1,348.96 |
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 $302.00 Median $338.84 Typical High $346.74 | Professional | 52 · Reduced service | $302.00 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $134.90 Typical High $141.25 | Professional | 53 · Discontinued | $120.23 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $524.81 | Professional | 54 · Surgery only | $457.09 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $104.71 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $67.61 Typical High $70.79 | Professional | 56 · Pre-op care only | $60.26 | $67.61 | $70.79 |
Where California sits
The same service costs 5.1 times more in Texas than in Delaware. 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· 40th of 51
$871
TX $3,981DE $776
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.