How much rates vary
Facilitymedian $1,413 · 10th to 90th $162 to $6,761Professionalmedian $141 · 10th to 90th $55 to $447
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 $154.88 Median $5,011.87 Typical High $15,135.61 | Facility | None | $154.88 | $5,011.87 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $131.83 Typical High $208.93 | Professional | None | $52.48 | $131.83 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $147.91 Typical High $154.88 | Professional | None | $138.04 | $147.91 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $151.36 Typical High $380.19 | Professional | None | $58.88 | $151.36 | $380.19 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,584.89 Typical High $6,165.95 | Facility | None | $100.00 | $1,584.89 | $6,165.95 |
Blue Shield Setting Professional Modifier None Typical Low $46.77 Median $112.20 Typical High $199.53 | Professional | None | $46.77 | $112.20 | $199.53 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $57.54 Median $169.82 Typical High $223.87 | Professional | None | $57.54 | $169.82 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $245.47 Typical High $1,348.96 | Facility | None | $154.88 | $245.47 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $144.54 Typical High $245.47 | Professional | None | $60.26 | $144.54 | $245.47 |
Contra Costa Health Setting Professional Modifier None Typical Low $51.29 Median $134.90 Typical High $218.78 | Professional | None | $51.29 | $134.90 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47.86 Median $151.36 Typical High $302.00 | Professional | None | $47.86 | $151.36 | $302.00 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,318.26 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $281.84 Typical High $2,754.23 | Facility | None | $144.54 | $281.84 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $144.54 Typical High $234.42 | Professional | None | $60.26 | $144.54 | $234.42 |
Sutter Health Plus Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $512.86 | Professional | None | $194.98 | $194.98 | $512.86 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $4,677.35 | Facility | None | $398.11 | $1,202.26 | $4,677.35 |
United Setting Professional Modifier None Typical Low $46.77 Median $120.23 Typical High $269.15 | Professional | None | $46.77 | $120.23 | $269.15 |
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 $27.54 Median $28.18 Typical High $77.62 | Facility | 52 · Reduced service | $27.54 | $28.18 | $77.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.96 Median $11.48 Typical High $30.90 | Facility | 53 · Discontinued | $10.96 | $11.48 | $30.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.32 Median $8.51 Typical High $23.44 | Facility | 55 · Aftercare only | $8.32 | $8.51 | $23.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.75 Typical High $15.49 | Facility | 56 · Pre-op care only | $5.50 | $5.75 | $15.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $39.81 Typical High $72.44 | Professional | 52 · Reduced service | $26.92 | $39.81 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $15.85 Typical High $28.84 | Professional | 53 · Discontinued | $10.72 | $15.85 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $60.26 Typical High $107.15 | Professional | 54 · Surgery only | $39.81 | $60.26 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.02 Typical High $21.38 | Professional | 55 · Aftercare only | $7.94 | $12.02 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.94 Typical High $14.45 | Professional | 56 · Pre-op care only | $5.37 | $7.94 | $14.45 |
Where California sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 22nd of 51
$151
AK $282MT $107
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.