How much rates vary
Facilitymedian $1,349 · 10th to 90th $117 to $6,310Professionalmedian $126 · 10th to 90th $79 to $457
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 $81.28 Median $123.03 Typical High $239.88 | Professional | None | $81.28 | $123.03 | $239.88 |
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 $77.62 Median $120.23 Typical High $371.54 | Professional | None | $77.62 | $120.23 | $371.54 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,584.89 Typical High $4,897.79 | Facility | None | $100.00 | $1,584.89 | $4,897.79 |
Blue Shield Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $190.55 | Professional | None | $72.44 | $104.71 | $190.55 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $199.53 | Professional | None | $79.43 | $134.90 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $169.82 Typical High $1,047.13 | Facility | None | $104.71 | $169.82 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $223.87 | Professional | None | $93.33 | $138.04 | $223.87 |
Contra Costa Health Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $194.98 | Professional | None | $85.11 | $102.33 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $295.12 | Professional | None | $79.43 | $154.88 | $295.12 |
Lucent Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,047.13 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $208.93 | Professional | None | $123.03 | $123.03 | $208.93 |
Providence Setting Facility Modifier None Typical Low $104.71 Median $194.98 Typical High $2,570.40 | Facility | None | $104.71 | $194.98 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $223.87 | Professional | None | $91.20 | $134.90 | $223.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $478.63 | Professional | None | $302.00 | $302.00 | $478.63 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $4,677.35 | Facility | None | $398.11 | $1,202.26 | $4,677.35 |
United Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $245.47 | Professional | None | $75.86 | $125.89 | $245.47 |
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 $41.69 Median $43.65 Typical High $70.79 | Facility | 52 · Reduced service | $41.69 | $43.65 | $70.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.98 Median $17.38 Typical High $28.18 | Facility | 53 · Discontinued | $16.98 | $17.38 | $28.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $63.10 Median $64.57 Typical High $107.15 | Facility | 54 · Surgery only | $63.10 | $64.57 | $107.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.59 Median $12.88 Typical High $21.38 | Facility | 55 · Aftercare only | $12.59 | $12.88 | $21.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.71 Typical High $14.13 | Facility | 56 · Pre-op care only | $8.32 | $8.71 | $14.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $57.54 Typical High $66.07 | Professional | 52 · Reduced service | $39.81 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $22.91 Typical High $26.30 | Professional | 53 · Discontinued | $16.22 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $85.11 Typical High $100.00 | Professional | 54 · Surgery only | $60.26 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $16.98 Typical High $19.95 | Professional | 55 · Aftercare only | $12.02 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $11.48 Typical High $13.18 | Professional | 56 · Pre-op care only | $7.94 | $11.48 | $13.18 |
Where California sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 42nd of 51
$132
AK $372FL $117
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.