How much rates vary
Facilitymedian $7,413 · 10th to 90th $933 to $28,184Professionalmedian $589 · 10th to 90th $457 to $3,802
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 $2,818.38 Median $10,000.00 Typical High $21,379.62 | Facility | None | $2,818.38 | $10,000.00 | $21,379.62 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $6,606.93 | Professional | None | $524.81 | $562.34 | $6,606.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,912.51 Typical High $16,982.44 | Facility | None | $4,786.30 | $8,912.51 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $977.24 | Professional | None | $537.03 | $562.34 | $977.24 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $1,548.82 Typical High $10,000.00 | Facility | None | $91.20 | $1,548.82 | $10,000.00 |
Blue Shield Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $776.25 | Professional | None | $323.59 | $457.09 | $776.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $537.03 | Professional | None | $436.52 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $20,417.38 Typical High $37,153.52 | Facility | None | $758.58 | $20,417.38 | $37,153.52 |
Contra Costa Health Setting Professional Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Professional | None | $21,379.62 | $21,379.62 | $21,379.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $794.33 | Professional | None | $398.11 | $457.09 | $794.33 |
Lucent Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,801.89 | Professional | None | $2,951.21 | $2,951.21 | $3,801.89 |
Providence Setting Facility Modifier None Typical Low $676.08 Median $19,952.62 Typical High $35,481.34 | Facility | None | $676.08 | $19,952.62 | $35,481.34 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $741.31 | Professional | None | $398.11 | $457.09 | $741.31 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $9,772.37 Typical High $30,199.52 | Facility | None | $4,265.80 | $9,772.37 | $30,199.52 |
United Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $1,819.70 | Professional | None | $478.63 | $724.44 | $1,819.70 |
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 $263.03 Median $281.84 Typical High $295.12 | Professional | 52 · Reduced service | $263.03 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $112.20 Typical High $120.23 | Professional | 53 · Discontinued | $104.71 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $426.58 Typical High $446.68 | Professional | 54 · Surgery only | $389.05 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $85.11 Typical High $89.13 | Professional | 55 · Aftercare only | $79.43 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $56.23 Typical High $58.88 | Professional | 56 · Pre-op care only | $52.48 | $56.23 | $58.88 |
Where California sits
The same service costs 27.5 times more in Oklahoma 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· 27th of 51
$1,349
OK $14,454NY $525
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.