How much rates vary
Facilitymedian $380 · 10th to 90th $85 to $5,495Professionalmedian $72 · 10th to 90th $36 to $288
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 $79.43 Median $7,079.46 Typical High $18,197.01 | Facility | None | $79.43 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $72.44 Typical High $151.36 | Professional | None | $38.02 | $72.44 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $169.82 | Professional | None | $114.82 | $114.82 | $169.82 |
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 $35.48 Median $69.18 Typical High $218.78 | Professional | None | $35.48 | $69.18 | $218.78 |
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 $30.20 Median $53.70 Typical High $95.50 | Professional | None | $30.20 | $53.70 | $95.50 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $37.15 Median $45.71 Typical High $165.96 | Professional | None | $37.15 | $45.71 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $134.90 Typical High $281.84 | Facility | None | $53.70 | $134.90 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $77.62 Typical High $154.88 | Professional | None | $41.69 | $77.62 | $154.88 |
Contra Costa Health Setting Professional Modifier None Typical Low $32.36 Median $44.67 Typical High $162.18 | Professional | None | $32.36 | $44.67 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $114.82 Typical High $223.87 | Professional | None | $37.15 | $114.82 | $223.87 |
Lucent Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Professional | None | $812.83 | $812.83 | $954.99 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $158.49 | Professional | None | $95.50 | $95.50 | $158.49 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $125.89 Typical High $275.42 | Facility | None | $50.12 | $125.89 | $275.42 |
Providence Setting Professional Modifier None Typical Low $41.69 Median $77.62 Typical High $151.36 | Professional | None | $41.69 | $77.62 | $151.36 |
Sutter Health Plus Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $389.05 | Professional | None | $151.36 | $151.36 | $389.05 |
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 $36.31 Median $87.10 Typical High $199.53 | Professional | None | $36.31 | $87.10 | $199.53 |
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 $19.50 Median $20.42 Typical High $43.65 | Facility | 52 · Reduced service | $19.50 | $20.42 | $43.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.76 Median $8.13 Typical High $17.38 | Facility | 53 · Discontinued | $7.76 | $8.13 | $17.38 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $29.51 Median $30.90 Typical High $66.07 | Facility | 54 · Surgery only | $29.51 | $30.90 | $66.07 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.89 Median $6.17 Typical High $13.18 | Facility | 55 · Aftercare only | $5.89 | $6.17 | $13.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.07 Typical High $8.71 | Facility | 56 · Pre-op care only | $3.89 | $4.07 | $8.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $32.36 Typical High $43.65 | Professional | 52 · Reduced service | $19.50 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $12.88 Typical High $17.38 | Professional | 53 · Discontinued | $7.76 | $12.88 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $48.98 Typical High $66.07 | Professional | 54 · Surgery only | $29.51 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $9.77 Typical High $13.18 | Professional | 55 · Aftercare only | $5.89 | $9.77 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.46 Typical High $8.71 | Professional | 56 · Pre-op care only | $3.89 | $6.46 | $8.71 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 59 · Distinct service | $120.23 | $120.23 | $120.23 |
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· 49th of 51
$75.86
AK $229KY $66.07
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.