How much rates vary
Facilitymedian $589 · 10th to 90th $76 to $6,310Professionalmedian $85 · 10th to 90th $43 to $302
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 $87.10 Median $7,079.46 Typical High $18,197.01 | Facility | None | $87.10 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $162.18 | Professional | None | $43.65 | $79.43 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $125.89 Typical High $131.83 | Professional | None | $56.23 | $125.89 | $131.83 |
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 $41.69 Median $74.13 Typical High $245.47 | Professional | None | $41.69 | $74.13 | $245.47 |
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 $40.74 Median $91.20 Typical High $154.88 | Professional | None | $40.74 | $91.20 | $154.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $40.74 Median $52.48 Typical High $169.82 | Professional | None | $40.74 | $52.48 | $169.82 |
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 $47.86 Median $85.11 Typical High $169.82 | Professional | None | $47.86 | $85.11 | $169.82 |
Contra Costa Health Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $165.96 | Professional | None | $33.88 | $51.29 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $123.03 Typical High $229.09 | Professional | None | $42.66 | $123.03 | $229.09 |
Lucent Health Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Professional | None | $870.96 | $870.96 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $169.82 | Professional | None | $100.00 | $100.00 | $169.82 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $676.08 | Facility | None | $50.12 | $66.07 | $676.08 |
Providence Setting Professional Modifier None Typical Low $47.86 Median $85.11 Typical High $158.49 | Professional | None | $47.86 | $85.11 | $158.49 |
Sutter Health Plus Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $407.38 | Professional | None | $169.82 | $169.82 | $407.38 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $40.74 Median $91.20 Typical High $208.93 | Professional | None | $40.74 | $91.20 | $208.93 |
11 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 $22.91 Median $23.99 Typical High $47.86 | Facility | 52 · Reduced service | $22.91 | $23.99 | $47.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.12 Median $9.55 Typical High $19.05 | Facility | 53 · Discontinued | $9.12 | $9.55 | $19.05 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $34.67 Median $36.31 Typical High $72.44 | Facility | 54 · Surgery only | $34.67 | $36.31 | $72.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.92 Median $7.24 Typical High $14.45 | Facility | 55 · Aftercare only | $6.92 | $7.24 | $14.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.79 Typical High $9.55 | Facility | 56 · Pre-op care only | $4.57 | $4.79 | $9.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $35.48 Typical High $47.86 | Professional | 52 · Reduced service | $22.39 | $35.48 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $14.45 Typical High $19.05 | Professional | 53 · Discontinued | $8.91 | $14.45 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $53.70 Typical High $72.44 | Professional | 54 · Surgery only | $33.11 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $10.72 Typical High $14.45 | Professional | 55 · Aftercare only | $6.61 | $10.72 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $7.08 Typical High $9.55 | Professional | 56 · Pre-op care only | $4.47 | $7.08 | $9.55 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 59 · Distinct service | $112.20 | $112.20 | $112.20 |
Where California sits
The same service costs 3.5 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· 47th of 51
$87.10
AK $257KY $72.44
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.