How much rates vary
Facilitymedian $417 · 10th to 90th $83 to $5,754Professionalmedian $115 · 10th to 90th $58 to $347
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 $57.54 Median $112.20 Typical High $177.83 | Professional | None | $57.54 | $112.20 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,897.79 Typical High $10,000.00 | Facility | None | $2,511.89 | $4,897.79 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $114.82 Typical High $288.40 | Professional | None | $57.54 | $114.82 | $288.40 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $1,479.11 | Facility | None | $97.72 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $52.48 Median $102.33 Typical High $239.88 | Professional | None | $52.48 | $102.33 | $239.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $45.71 Median $104.71 Typical High $141.25 | Professional | None | $45.71 | $104.71 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $102.33 Typical High $213.80 | Facility | None | $53.70 | $102.33 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $125.89 Typical High $199.53 | Professional | None | $64.57 | $125.89 | $199.53 |
Contra Costa Health Setting Professional Modifier None Typical Low $50.12 Median $74.13 Typical High $141.25 | Professional | None | $50.12 | $74.13 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $107.15 Typical High $245.47 | Professional | None | $46.77 | $107.15 | $245.47 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | None | $724.44 | $724.44 | $870.96 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $141.25 | Professional | None | $85.11 | $85.11 | $141.25 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $102.33 Typical High $213.80 | Facility | None | $56.23 | $102.33 | $213.80 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $125.89 Typical High $204.17 | Professional | None | $64.57 | $125.89 | $204.17 |
Sutter Health Plus Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $323.59 | Professional | None | $181.97 | $181.97 | $323.59 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,090.30 | Facility | None | $123.03 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $50.12 Median $100.00 Typical High $234.42 | Professional | None | $50.12 | $100.00 | $234.42 |
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 $30.90 Median $31.62 Typical High $74.13 | Facility | 52 · Reduced service | $30.90 | $31.62 | $74.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.30 Median $12.59 Typical High $29.51 | Facility | 53 · Discontinued | $12.30 | $12.59 | $29.51 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $46.77 Median $47.86 Typical High $109.65 | Facility | 54 · Surgery only | $46.77 | $47.86 | $109.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.33 Median $9.55 Typical High $21.88 | Facility | 55 · Aftercare only | $9.33 | $9.55 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.31 Typical High $14.79 | Facility | 56 · Pre-op care only | $6.17 | $6.31 | $14.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $42.66 Typical High $67.61 | Professional | 52 · Reduced service | $29.51 | $42.66 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $16.98 Typical High $26.92 | Professional | 53 · Discontinued | $11.75 | $16.98 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $64.57 Typical High $100.00 | Professional | 54 · Surgery only | $43.65 | $64.57 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.88 Typical High $20.42 | Professional | 55 · Aftercare only | $8.91 | $12.88 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.51 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.89 | $8.51 | $13.49 |
Where California sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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
$120
AK $257PA $93.33
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.