How much rates vary
Facilitymedian $631 · 10th to 90th $93 to $5,370Professionalmedian $17 · 10th to 90th $14 to $44
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 $16.98 Median $7,079.46 Typical High $18,197.01 | Facility | None | $16.98 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $16.98 Typical High $29.51 | Professional | None | $14.13 | $16.98 | $29.51 |
Ambetter Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $10,000.00 | Facility | None | $2,137.96 | $4,786.30 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $15.14 Typical High $52.48 | Professional | None | $13.80 | $15.14 | $52.48 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $416.87 Typical High $1,513.56 | Facility | None | $91.20 | $416.87 | $1,513.56 |
Blue Shield Setting Professional Modifier None Typical Low $11.75 Median $16.98 Typical High $25.70 | Professional | None | $11.75 | $16.98 | $25.70 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $13.18 Median $17.78 Typical High $24.55 | Professional | None | $13.18 | $17.78 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $1,202.26 Typical High $2,691.53 | Facility | None | $50.12 | $1,202.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $18.62 Typical High $29.51 | Professional | None | $15.85 | $18.62 | $29.51 |
Contra Costa Health Setting Professional Modifier None Typical Low $12.59 Median $15.85 Typical High $23.99 | Professional | None | $12.59 | $15.85 | $23.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $13.18 Median $19.95 Typical High $40.74 | Professional | None | $13.18 | $19.95 | $40.74 |
Lucent Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Molina Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $26.30 | Professional | None | $15.85 | $15.85 | $26.30 |
Providence Setting Facility Modifier None Typical Low $16.22 Median $40.74 Typical High $2,511.89 | Facility | None | $16.22 | $40.74 | $2,511.89 |
Providence Setting Professional Modifier None Typical Low $15.49 Median $18.62 Typical High $29.51 | Professional | None | $15.49 | $18.62 | $29.51 |
Sutter Health Plus Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $60.26 | Professional | None | $53.70 | $53.70 | $60.26 |
United Setting Facility Modifier None Typical Low $147.91 Median $630.96 Typical High $1,778.28 | Facility | None | $147.91 | $630.96 | $1,778.28 |
United Setting Professional Modifier None Typical Low $12.88 Median $16.98 Typical High $33.11 | Professional | None | $12.88 | $16.98 | $33.11 |
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 $7.41 Median $7.76 Typical High $8.91 | Facility | 52 · Reduced service | $7.41 | $7.76 | $8.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.95 Median $3.09 Typical High $3.55 | Facility | 53 · Discontinued | $2.95 | $3.09 | $3.55 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $11.22 Median $11.48 Typical High $13.49 | Facility | 54 · Surgery only | $11.22 | $11.48 | $13.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.24 Median $2.29 Typical High $2.69 | Facility | 55 · Aftercare only | $2.24 | $2.29 | $2.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.55 Typical High $1.78 | Facility | 56 · Pre-op care only | $1.48 | $1.55 | $1.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $7.76 Typical High $8.51 | Professional | 52 · Reduced service | $7.08 | $7.76 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $3.09 Typical High $3.39 | Professional | 53 · Discontinued | $2.82 | $3.09 | $3.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.47 Median $11.48 Typical High $12.59 | Professional | 54 · Surgery only | $10.47 | $11.48 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.29 Typical High $2.51 | Professional | 55 · Aftercare only | $2.14 | $2.29 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.55 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.41 | $1.55 | $1.70 |
Where California sits
The same service costs 3.9 times more in Alaska than in New Jersey. 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· 42nd of 51
$18.20
AK $64.57NJ $16.60
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.