How much rates vary
Facilitymedian $389 · 10th to 90th $93 to $5,495Professionalmedian $107 · 10th to 90th $62 to $398
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 $114.82 Median $7,079.46 Typical High $18,197.01 | Facility | None | $114.82 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $107.15 Typical High $208.93 | Professional | None | $63.10 | $107.15 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $151.36 | Professional | None | $144.54 | $144.54 | $151.36 |
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 $60.26 Median $100.00 Typical High $331.13 | Professional | None | $60.26 | $100.00 | $331.13 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $1,479.11 | Facility | None | $97.72 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $141.25 | Professional | None | $50.12 | $79.43 | $141.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $218.78 | Professional | None | $51.29 | $75.86 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $169.82 Typical High $354.81 | Facility | None | $53.70 | $169.82 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $112.20 Typical High $218.78 | Professional | None | $69.18 | $112.20 | $218.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $43.65 Median $74.13 Typical High $213.80 | Professional | None | $43.65 | $74.13 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $162.18 Typical High $295.12 | Professional | None | $61.66 | $162.18 | $295.12 |
Lucent Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,122.02 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $213.80 | Professional | None | $128.82 | $128.82 | $213.80 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $162.18 Typical High $346.74 | Facility | None | $58.88 | $162.18 | $346.74 |
Providence Setting Professional Modifier None Typical Low $69.18 Median $112.20 Typical High $208.93 | Professional | None | $69.18 | $112.20 | $208.93 |
Sutter Health Plus Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $524.81 | Professional | None | $245.47 | $245.47 | $524.81 |
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 $58.88 Median $123.03 Typical High $275.42 | Professional | None | $58.88 | $123.03 | $275.42 |
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 $33.11 Median $34.67 Typical High $63.10 | Facility | 52 · Reduced service | $33.11 | $34.67 | $63.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.18 Median $13.80 Typical High $25.12 | Facility | 53 · Discontinued | $13.18 | $13.80 | $25.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $48.98 Median $52.48 Typical High $95.50 | Facility | 54 · Surgery only | $48.98 | $52.48 | $95.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.00 Median $10.47 Typical High $19.05 | Facility | 55 · Aftercare only | $10.00 | $10.47 | $19.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.92 Typical High $12.59 | Facility | 56 · Pre-op care only | $6.61 | $6.92 | $12.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $47.86 Typical High $63.10 | Professional | 52 · Reduced service | $32.36 | $47.86 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $19.05 Typical High $25.12 | Professional | 53 · Discontinued | $12.88 | $19.05 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $72.44 Typical High $95.50 | Professional | 54 · Surgery only | $47.86 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $14.45 Typical High $19.05 | Professional | 55 · Aftercare only | $9.55 | $14.45 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $9.55 Typical High $12.59 | Professional | 56 · Pre-op care only | $6.46 | $9.55 | $12.59 |
Where California sits
The same service costs 3.2 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
$112
AK $309KY $97.72
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.