How much rates vary
Facilitymedian $589 · 10th to 90th $66 to $6,310Professionalmedian $58 · 10th to 90th $26 to $245
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 $60.26 Median $6,918.31 Typical High $18,197.01 | Facility | None | $60.26 | $6,918.31 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $58.88 Typical High $123.03 | Professional | None | $26.92 | $58.88 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $104.71 Typical High $109.65 | Professional | None | $93.33 | $104.71 | $109.65 |
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 $24.55 Median $54.95 Typical High $181.97 | Professional | None | $24.55 | $54.95 | $181.97 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $416.87 Typical High $1,479.11 | Facility | None | $95.50 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $20.89 Median $42.66 Typical High $75.86 | Professional | None | $20.89 | $42.66 | $75.86 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $28.18 Median $38.02 Typical High $144.54 | Professional | None | $28.18 | $38.02 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $676.08 | Facility | None | $50.12 | $61.66 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $61.66 Typical High $134.90 | Professional | None | $28.18 | $61.66 | $134.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $26.30 Median $33.88 Typical High $141.25 | Professional | None | $26.30 | $33.88 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.18 Median $93.33 Typical High $194.98 | Professional | None | $28.18 | $93.33 | $194.98 |
Lucent Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | None | $707.95 | $707.95 | $831.76 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $138.04 | Professional | None | $83.18 | $83.18 | $138.04 |
Providence Setting Facility Modifier None Typical Low $34.67 Median $64.57 Typical High $676.08 | Facility | None | $34.67 | $64.57 | $676.08 |
Providence Setting Professional Modifier None Typical Low $28.18 Median $61.66 Typical High $134.90 | Professional | None | $28.18 | $61.66 | $134.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $338.84 | Professional | None | $112.20 | $112.20 | $338.84 |
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 $26.92 Median $72.44 Typical High $169.82 | Professional | None | $26.92 | $72.44 | $169.82 |
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 $13.49 Median $13.80 Typical High $36.31 | Facility | 52 · Reduced service | $13.49 | $13.80 | $36.31 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.37 Median $5.62 Typical High $14.45 | Facility | 53 · Discontinued | $5.37 | $5.62 | $14.45 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $19.95 Median $20.89 Typical High $53.70 | Facility | 54 · Surgery only | $19.95 | $20.89 | $53.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.98 Median $4.17 Typical High $10.72 | Facility | 55 · Aftercare only | $3.98 | $4.17 | $10.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.82 Typical High $7.24 | Facility | 56 · Pre-op care only | $2.69 | $2.82 | $7.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.49 Median $25.70 Typical High $36.31 | Professional | 52 · Reduced service | $13.49 | $25.70 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $10.23 Typical High $14.45 | Professional | 53 · Discontinued | $5.37 | $10.23 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $38.90 Typical High $53.70 | Professional | 54 · Surgery only | $19.95 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $7.76 Typical High $10.72 | Professional | 55 · Aftercare only | $3.98 | $7.76 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $5.13 Typical High $7.24 | Professional | 56 · Pre-op care only | $2.69 | $5.13 | $7.24 |
Where California sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 48th of 51
$61.66
AK $170KY $51.29
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.