How much rates vary
Facilitymedian $759 · 10th to 90th $129 to $6,026Professionalmedian $182 · 10th to 90th $100 to $741
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 $354.81 Median $5,128.61 Typical High $15,135.61 | Facility | None | $354.81 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $234.42 | Professional | None | $93.33 | $144.54 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $478.63 | Professional | None | $147.91 | $204.17 | $478.63 |
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 $128.82 Median $186.21 Typical High $331.13 | Professional | None | $128.82 | $186.21 | $331.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $295.12 | Professional | None | $102.33 | $162.18 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $177.83 Typical High $371.54 | Facility | None | $53.70 | $177.83 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $173.78 Typical High $281.84 | Professional | None | $95.50 | $173.78 | $281.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $288.40 | Professional | None | $93.33 | $112.20 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $223.87 Typical High $407.38 | Professional | None | $89.13 | $223.87 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,548.82 | $1,548.82 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $245.47 | Professional | None | $147.91 | $147.91 | $245.47 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $181.97 Typical High $446.68 | Facility | None | $61.66 | $181.97 | $446.68 |
Providence Setting Professional Modifier None Typical Low $95.50 Median $173.78 Typical High $275.42 | Professional | None | $95.50 | $173.78 | $275.42 |
Sutter Health Plus Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $549.54 | Professional | None | $302.00 | $302.00 | $549.54 |
United Setting Facility Modifier None Typical Low $147.91 Median $933.25 Typical High $1,778.28 | Facility | None | $147.91 | $933.25 | $1,778.28 |
United Setting Professional Modifier None Typical Low $77.62 Median $151.36 Typical High $323.59 | Professional | None | $77.62 | $151.36 | $323.59 |
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 $50.12 Median $52.48 Typical High $89.13 | Facility | 52 · Reduced service | $50.12 | $52.48 | $89.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.95 Median $20.89 Typical High $36.31 | Facility | 53 · Discontinued | $19.95 | $20.89 | $36.31 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $75.86 Median $77.62 Typical High $134.90 | Facility | 54 · Surgery only | $75.86 | $77.62 | $134.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $26.92 | Facility | 55 · Aftercare only | $15.14 | $15.49 | $26.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.47 Typical High $17.78 | Facility | 56 · Pre-op care only | $10.00 | $10.47 | $17.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $66.07 Typical High $83.18 | Professional | 52 · Reduced service | $47.86 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $26.30 Typical High $33.11 | Professional | 53 · Discontinued | $19.05 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $100.00 Typical High $125.89 | Professional | 54 · Surgery only | $70.79 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $19.95 Typical High $25.12 | Professional | 55 · Aftercare only | $14.45 | $19.95 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $13.18 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.55 | $13.18 | $16.60 |
Where California sits
The same service costs 11.6 times more in Hawaii 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.
Physician feeFacility fee
HI $3,027MD $261
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.