How much rates vary
Facilitymedian $759 · 10th to 90th $83 to $6,607Professionalmedian $49 · 10th to 90th $25 to $158
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 $478.63 Median $5,128.61 Typical High $15,135.61 | Facility | None | $478.63 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $47.86 Typical High $63.10 | Professional | None | $25.70 | $47.86 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $10,000.00 | Facility | None | $2,137.96 | $4,786.30 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $47.86 Typical High $138.04 | Professional | None | $24.55 | $47.86 | $138.04 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $416.87 Typical High $1,513.56 | Facility | None | $95.50 | $416.87 | $1,513.56 |
Blue Shield Setting Professional Modifier None Typical Low $22.39 Median $47.86 Typical High $83.18 | Professional | None | $22.39 | $47.86 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $1,202.26 Typical High $2,691.53 | Facility | None | $50.12 | $1,202.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $57.54 Typical High $95.50 | Professional | None | $29.51 | $57.54 | $95.50 |
Contra Costa Health Setting Professional Modifier None Typical Low $26.92 Median $36.31 Typical High $93.33 | Professional | None | $26.92 | $36.31 | $93.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $24.55 Median $70.79 Typical High $158.49 | Professional | None | $24.55 | $70.79 | $158.49 |
Lucent Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $29.51 Median $74.13 Typical High $2,691.53 | Facility | None | $29.51 | $74.13 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $29.51 Median $58.88 Typical High $93.33 | Professional | None | $29.51 | $58.88 | $93.33 |
Sutter Health Plus Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $199.53 | Professional | None | $95.50 | $95.50 | $199.53 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $3,090.30 | Facility | None | $123.03 | $537.03 | $3,090.30 |
United Setting Professional Modifier None Typical Low $23.44 Median $47.86 Typical High $104.71 | Professional | None | $23.44 | $47.86 | $104.71 |
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 $13.18 Median $13.80 Typical High $31.62 | Facility | 52 · Reduced service | $13.18 | $13.80 | $31.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.37 Median $5.62 Typical High $12.59 | Facility | 53 · Discontinued | $5.37 | $5.62 | $12.59 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $19.95 Median $20.89 Typical High $47.86 | Facility | 54 · Surgery only | $19.95 | $20.89 | $47.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.98 Median $4.17 Typical High $9.55 | Facility | 55 · Aftercare only | $3.98 | $4.17 | $9.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.82 Typical High $6.31 | Facility | 56 · Pre-op care only | $2.69 | $2.82 | $6.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $22.91 Typical High $28.84 | Professional | 52 · Reduced service | $12.59 | $22.91 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $9.33 Typical High $11.48 | Professional | 53 · Discontinued | $5.01 | $9.33 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $34.67 Typical High $42.66 | Professional | 54 · Surgery only | $19.05 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $6.92 Typical High $8.51 | Professional | 55 · Aftercare only | $3.80 | $6.92 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $4.57 Typical High $5.75 | Professional | 56 · Pre-op care only | $2.51 | $4.57 | $5.75 |
Where California sits
The same service costs 4.0 times more in Alaska than in Texas. 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· 38th of 51
$53.70
AK $148TX $37.15
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.