How much rates vary
Facilitymedian $389 · 10th to 90th $71 to $5,495Professionalmedian $65 · 10th to 90th $42 to $372
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 $64.57 Median $7,079.46 Typical High $18,197.01 | Facility | None | $64.57 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $57.54 Typical High $70.79 | Professional | None | $42.66 | $57.54 | $70.79 |
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 $60.26 Typical High $213.80 | Professional | None | $41.69 | $60.26 | $213.80 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $426.58 Typical High $1,479.11 | Facility | None | $97.72 | $426.58 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $35.48 Median $56.23 Typical High $104.71 | Professional | None | $35.48 | $56.23 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $91.20 Typical High $190.55 | Facility | None | $53.70 | $91.20 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $74.13 Typical High $123.03 | Professional | None | $48.98 | $74.13 | $123.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $123.03 | Professional | None | $48.98 | $66.07 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $93.33 Typical High $169.82 | Professional | None | $45.71 | $93.33 | $169.82 |
Lucent Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | None | $630.96 | $630.96 | $758.58 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $114.82 | Professional | None | $69.18 | $69.18 | $114.82 |
Providence Setting Facility Modifier None Typical Low $53.70 Median $91.20 Typical High $190.55 | Facility | None | $53.70 | $91.20 | $190.55 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $74.13 Typical High $125.89 | Professional | None | $48.98 | $74.13 | $125.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $263.03 | Professional | None | $169.82 | $169.82 | $263.03 |
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 $66.07 Typical High $144.54 | Professional | None | $40.74 | $66.07 | $144.54 |
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 $21.88 Median $22.91 Typical High $35.48 | Facility | 52 · Reduced service | $21.88 | $22.91 | $35.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.71 Median $9.12 Typical High $14.13 | Facility | 53 · Discontinued | $8.71 | $9.12 | $14.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $32.36 Median $33.88 Typical High $52.48 | Facility | 54 · Surgery only | $32.36 | $33.88 | $52.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.46 Median $6.92 Typical High $10.47 | Facility | 55 · Aftercare only | $6.46 | $6.92 | $10.47 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.57 Typical High $7.08 | Facility | 56 · Pre-op care only | $4.37 | $4.57 | $7.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $28.84 Typical High $35.48 | Professional | 52 · Reduced service | $21.38 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $11.48 Typical High $14.13 | Professional | 53 · Discontinued | $8.71 | $11.48 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $42.66 Typical High $52.48 | Professional | 54 · Surgery only | $32.36 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $8.71 Typical High $10.47 | Professional | 55 · Aftercare only | $6.46 | $8.71 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $5.75 Typical High $7.08 | Professional | 56 · Pre-op care only | $4.27 | $5.75 | $7.08 |
Where California sits
The same service costs 3.4 times more in Alaska than in New York. 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· 41st of 51
$72.44
AK $209NY $61.66
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.