How much rates vary
Facilitymedian $1,023 · 10th to 90th $63 to $12,023Professionalmedian $62 · 10th to 90th $28 to $537
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 $933.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None (both parts) Typical Low $67.61 Median $72.44 Typical High $79.43 | Professional | None (both parts) | $67.61 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $24.55 Median $26.30 Typical High $28.18 | Professional | 26 · Professional part | $24.55 | $26.30 | $28.18 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $43.65 Median $46.77 Typical High $52.48 | Professional | TC · Technical part | $43.65 | $46.77 | $52.48 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $28.18 Median $56.23 Typical High $75.86 | Professional | None (both parts) | $28.18 | $56.23 | $75.86 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $29.51 Median $29.51 Typical High $45.71 | Professional | 26 · Professional part | $29.51 | $29.51 | $45.71 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $25.70 Median $26.30 Typical High $53.70 | Professional | TC · Technical part | $25.70 | $26.30 | $53.70 |
Blue Shield Setting Facility Modifier None Typical Low $63.10 Median $870.96 Typical High $1,905.46 | Facility | None | $63.10 | $870.96 | $1,905.46 |
Blue Shield Setting Professional Modifier None (both parts) Typical Low $23.99 Median $56.23 Typical High $79.43 | Professional | None (both parts) | $23.99 | $56.23 | $79.43 |
Central California Alliance for Health Setting Professional Modifier None (both parts) Typical Low $33.11 Median $40.74 Typical High $100.00 | Professional | None (both parts) | $33.11 | $40.74 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $47.86 Typical High $141.25 | Facility | None | $43.65 | $47.86 | $141.25 |
Cigna Setting Professional Modifier None (both parts) Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None (both parts) | $354.81 | $354.81 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.90 Median $67.61 Typical High $131.83 | Professional | None | $30.90 | $67.61 | $131.83 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $537.03 Median $537.03 Typical High $630.96 | Professional | None (both parts) | $537.03 | $537.03 | $630.96 |
Lucent Health Setting Professional Modifier 26 · Professional part Typical Low $208.93 Median $208.93 Typical High $229.09 | Professional | 26 · Professional part | $208.93 | $208.93 | $229.09 |
Lucent Health Setting Professional Modifier TC · Technical part Typical Low $323.59 Median $323.59 Typical High $407.38 | Professional | TC · Technical part | $323.59 | $323.59 | $407.38 |
Providence Setting Facility Modifier None Typical Low $44.67 Median $95.50 Typical High $123.03 | Facility | None | $44.67 | $95.50 | $123.03 |
Providence Setting Professional Modifier None (both parts) Typical Low $33.11 Median $125.89 Typical High $354.81 | Professional | None (both parts) | $33.11 | $125.89 | $354.81 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $93.33 | Facility | None | $61.66 | $61.66 | $93.33 |
United Setting Professional Modifier None (both parts) Typical Low $57.54 Median $77.62 Typical High $169.82 | Professional | None (both parts) | $57.54 | $77.62 | $169.82 |
United Setting Professional Modifier 26 · Professional part Typical Low $22.91 Median $29.51 Typical High $61.66 | Professional | 26 · Professional part | $22.91 | $29.51 | $61.66 |
United Setting Professional Modifier TC · Technical part Typical Low $35.48 Median $47.86 Typical High $107.15 | Professional | TC · Technical part | $35.48 | $47.86 | $107.15 |
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 $33.88 Median $36.31 Typical High $39.81 | Professional | 52 · Reduced service | $33.88 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.45 Typical High $15.85 | Professional | 53 · Discontinued | $13.80 | $14.45 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $54.95 Typical High $58.88 | Professional | 54 · Surgery only | $51.29 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.96 Typical High $12.02 | Professional | 55 · Aftercare only | $10.23 | $10.96 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.24 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.76 | $7.24 | $7.94 |
Where California sits
The same service costs 4.4 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· 44th of 51
$64.57
TX $174NY $39.81
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.