How much rates vary
Facilitymedian $1,660 · 10th to 90th $155 to $8,913Professionalmedian $257 · 10th to 90th $83 to $1,288
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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $1,584.89 | Professional | None | $223.87 | $245.47 | $1,584.89 |
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 $83.18 Median $288.40 Typical High $467.74 | Professional | None | $83.18 | $288.40 | $467.74 |
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 $128.82 Median $186.21 Typical High $371.54 | Professional | None | $128.82 | $186.21 | $371.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $234.42 | Professional | None | $66.07 | $79.43 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $954.99 Typical High $2,691.53 | Facility | None | $630.96 | $954.99 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $741.31 | Professional | None | $199.53 | $309.03 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $162.18 Typical High $416.87 | Professional | None | $66.07 | $162.18 | $416.87 |
Lucent Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,288.25 | $1,698.24 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $758.58 Typical High $2,691.53 | Facility | None | $190.55 | $758.58 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $891.25 | Professional | None | $186.21 | $302.00 | $891.25 |
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 $141.25 Median $245.47 Typical High $630.96 | Professional | None | $141.25 | $245.47 | $630.96 |
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 $112.20 Median $123.03 Typical High $125.89 | Professional | 52 · Reduced service | $112.20 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $48.98 Typical High $50.12 | Professional | 53 · Discontinued | $44.67 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $181.97 Typical High $190.55 | Professional | 54 · Surgery only | $169.82 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $36.31 Typical High $38.02 | Professional | 55 · Aftercare only | $33.88 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $24.55 Typical High $25.12 | Professional | 56 · Pre-op care only | $22.39 | $24.55 | $25.12 |
Where California sits
The same service costs 7.2 times more in Oklahoma than in Virginia. 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· 23rd of 51
$295
OK $1,000VA $138
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.