How much rates vary
Facilitymedian $5,012 · 10th to 90th $617 to $151,356Professionalmedian $1,479 · 10th to 90th $1,259 to $10,233
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 $1,412.54 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,412.54 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,412.54 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $14,125.38 Typical High $25,118.86 | Facility | None | $7,244.36 | $14,125.38 | $25,118.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,348.96 | $2,570.40 |
Blue Shield Setting Facility Modifier None Typical Low $64.57 Median $2,630.27 Typical High $6,456.54 | Facility | None | $64.57 | $2,630.27 | $6,456.54 |
Blue Shield Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,023.29 | $1,445.44 | $2,570.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,137.96 Typical High $22,387.21 | Facility | None | $660.69 | $2,137.96 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,513.56 | $1,513.56 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,513.56 | $2,630.27 |
Lucent Health Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $12,589.25 | Professional | None | $10,232.93 | $10,232.93 | $12,589.25 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $812.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $2,570.40 | Professional | None | $1,412.54 | $1,513.56 | $2,570.40 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $4,570.88 | Professional | None | $1,122.02 | $1,698.24 | $4,570.88 |
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 $602.56 Median $676.08 Typical High $707.95 | Professional | 52 · Reduced service | $602.56 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $269.15 Typical High $281.84 | Professional | 53 · Discontinued | $245.47 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,000.00 Typical High $1,047.13 | Professional | 54 · Surgery only | $912.01 | $1,000.00 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $204.17 Typical High $213.80 | Professional | 55 · Aftercare only | $181.97 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $134.90 Typical High $141.25 | Professional | 56 · Pre-op care only | $123.03 | $134.90 | $141.25 |
Where California sits
The same service costs 6.8 times more in Alaska than in Arkansas. 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· 26th of 51
$1,660
AK $5,888AR $871
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.