How much rates vary
Facilitymedian $1,549 · 10th to 90th $141 to $8,710Professionalmedian $269 · 10th to 90th $78 to $1,230
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 $478.63 Median $5,128.61 Typical High $15,135.61 | Facility | None | $478.63 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $245.47 Typical High $295.12 | Professional | None | $74.13 | $245.47 | $295.12 |
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 $79.43 Median $288.40 Typical High $794.33 | Professional | None | $79.43 | $288.40 | $794.33 |
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 $63.10 Median $229.09 Typical High $457.09 | Professional | None | $63.10 | $229.09 | $457.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $64.57 Median $281.84 Typical High $389.05 | Professional | None | $64.57 | $281.84 | $389.05 |
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 $81.28 Median $275.42 Typical High $501.19 | Professional | None | $81.28 | $275.42 | $501.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $69.18 Median $257.04 Typical High $338.84 | Professional | None | $69.18 | $257.04 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $223.87 Typical High $575.44 | Professional | None | $66.07 | $223.87 | $575.44 |
Lucent Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,698.24 | $2,041.74 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $257.04 | Professional | None | $151.36 | $151.36 | $257.04 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $691.83 Typical High $2,691.53 | Facility | None | $87.10 | $691.83 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $81.28 Median $275.42 Typical High $501.19 | Professional | None | $81.28 | $275.42 | $501.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $954.99 | Professional | None | $269.15 | $269.15 | $954.99 |
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 $69.18 Median $234.42 Typical High $537.03 | Professional | None | $69.18 | $234.42 | $537.03 |
9 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 $38.02 Median $38.90 Typical High $147.91 | Facility | 52 · Reduced service | $38.02 | $38.90 | $147.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.14 Median $15.49 Typical High $58.88 | Facility | 53 · Discontinued | $15.14 | $15.49 | $58.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $11.48 Typical High $44.67 | Facility | 55 · Aftercare only | $11.22 | $11.48 | $44.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.76 Typical High $29.51 | Facility | 56 · Pre-op care only | $7.59 | $7.76 | $29.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $100.00 Typical High $134.90 | Professional | 52 · Reduced service | $36.31 | $100.00 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $39.81 Typical High $54.95 | Professional | 53 · Discontinued | $14.79 | $39.81 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $147.91 Typical High $204.17 | Professional | 54 · Surgery only | $54.95 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $30.20 Typical High $40.74 | Professional | 55 · Aftercare only | $10.96 | $30.20 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $19.95 Typical High $26.92 | Professional | 56 · Pre-op care only | $7.41 | $19.95 | $26.92 |
Where California sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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· 12th of 51
$288
OK $575NE $129
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.