How much rates vary
Facilitymedian $1,514 · 10th to 90th $120 to $8,710Professionalmedian $59 · 10th to 90th $45 to $195
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 $57.54 Median $4,897.79 Typical High $15,135.61 | Facility | None | $57.54 | $4,897.79 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $93.33 | Professional | None | $43.65 | $54.95 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $52.48 Median $91.20 Typical High $323.59 | Professional | None | $52.48 | $91.20 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $5,011.87 Typical High $10,000.00 | Facility | None | $2,511.89 | $5,011.87 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $58.88 Typical High $169.82 | Professional | None | $47.86 | $58.88 | $169.82 |
Blue Shield Setting Facility Modifier None Typical Low $457.09 Median $1,202.26 Typical High $1,202.26 | Facility | None | $457.09 | $1,202.26 | $1,202.26 |
Blue Shield Setting Professional Modifier None Typical Low $38.02 Median $61.66 Typical High $144.54 | Professional | None | $38.02 | $61.66 | $144.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $43.65 Median $64.57 Typical High $79.43 | Professional | None | $43.65 | $64.57 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,000.00 Typical High $2,691.53 | Facility | None | $630.96 | $1,000.00 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $63.10 Typical High $123.03 | Professional | None | $48.98 | $63.10 | $123.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $46.77 Median $56.23 Typical High $77.62 | Professional | None | $46.77 | $56.23 | $77.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $64.57 Typical High $138.04 | Professional | None | $43.65 | $64.57 | $138.04 |
Lucent Health Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $512.86 | Professional | None | $436.52 | $512.86 | $512.86 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $70.79 | Professional | None | $42.66 | $42.66 | $70.79 |
Providence Setting Facility Modifier None Typical Low $54.95 Median $691.83 Typical High $2,691.53 | Facility | None | $54.95 | $691.83 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $61.66 Typical High $125.89 | Professional | None | $48.98 | $61.66 | $125.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $194.98 | Professional | None | $162.18 | $162.18 | $194.98 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $3,090.30 | Facility | None | $123.03 | $537.03 | $3,090.30 |
United Setting Professional Modifier None Typical Low $40.74 Median $61.66 Typical High $144.54 | Professional | None | $40.74 | $61.66 | $144.54 |
10 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 Facility Modifier 52 · Reduced service Typical Low $22.39 Median $22.91 Typical High $28.18 | Facility | 52 · Reduced service | $22.39 | $22.91 | $28.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.91 Median $9.12 Typical High $11.48 | Facility | 53 · Discontinued | $8.91 | $9.12 | $11.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.76 Median $6.92 Typical High $8.51 | Facility | 55 · Aftercare only | $6.76 | $6.92 | $8.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.57 Typical High $5.75 | Facility | 56 · Pre-op care only | $4.47 | $4.57 | $5.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $25.12 Typical High $28.18 | Professional | 52 · Reduced service | $21.88 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $10.23 Typical High $11.48 | Professional | 53 · Discontinued | $8.71 | $10.23 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $38.02 Typical High $42.66 | Professional | 54 · Surgery only | $33.11 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.59 Typical High $8.51 | Professional | 55 · Aftercare only | $6.61 | $7.59 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.13 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.37 | $5.13 | $5.75 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 59 · Distinct service | $51.29 | $51.29 | $51.29 |
Where California sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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· 46th of 51
$61.66
AK $240KY $50.12
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.