How much rates vary
Facilitymedian $389 · 10th to 90th $100 to $5,495Professionalmedian $132 · 10th to 90th $81 to $589
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 $141.25 Median $7,079.46 Typical High $18,197.01 | Facility | None | $141.25 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $213.80 | Professional | None | $83.18 | $128.82 | $213.80 |
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 $79.43 Median $125.89 Typical High $380.19 | Professional | None | $79.43 | $125.89 | $380.19 |
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 $67.61 Median $100.00 Typical High $181.97 | Professional | None | $67.61 | $100.00 | $181.97 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $66.07 Median $95.50 Typical High $251.19 | Professional | None | $66.07 | $95.50 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $194.98 Typical High $426.58 | Facility | None | $56.23 | $194.98 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $269.15 | Professional | None | $93.33 | $144.54 | $269.15 |
Contra Costa Health Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $251.19 | Professional | None | $54.95 | $95.50 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $186.21 Typical High $346.74 | Professional | None | $79.43 | $186.21 | $346.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,288.25 | $1,288.25 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $251.19 | Professional | None | $151.36 | $151.36 | $251.19 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $190.55 Typical High $389.05 | Facility | None | $66.07 | $190.55 | $389.05 |
Providence Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $251.19 | Professional | None | $93.33 | $144.54 | $251.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $616.60 | Professional | None | $323.59 | $323.59 | $616.60 |
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 $77.62 Median $144.54 Typical High $316.23 | Professional | None | $77.62 | $144.54 | $316.23 |
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 $43.65 Median $45.71 Typical High $77.62 | Facility | 52 · Reduced service | $43.65 | $45.71 | $77.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.78 Median $18.62 Typical High $30.90 | Facility | 53 · Discontinued | $17.78 | $18.62 | $30.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $66.07 Median $69.18 Typical High $117.49 | Facility | 54 · Surgery only | $66.07 | $69.18 | $117.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.18 Median $13.80 Typical High $23.44 | Facility | 55 · Aftercare only | $13.18 | $13.80 | $23.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.33 Typical High $15.49 | Facility | 56 · Pre-op care only | $8.71 | $9.33 | $15.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $60.26 Typical High $77.62 | Professional | 52 · Reduced service | $41.69 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $23.99 Typical High $30.90 | Professional | 53 · Discontinued | $16.60 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $91.20 Typical High $117.49 | Professional | 54 · Surgery only | $63.10 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $18.20 Typical High $23.44 | Professional | 55 · Aftercare only | $12.59 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $12.02 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.32 | $12.02 | $15.49 |
Where California sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 46th of 51
$141
AK $398MD $120
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.