How much rates vary
Facilitymedian $1,622 · 10th to 90th $138 to $7,762Professionalmedian $182 · 10th to 90th $117 to $646
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 $645.65 Median $5,888.44 Typical High $15,848.93 | Facility | None | $645.65 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $218.78 | Professional | None | $123.03 | $173.78 | $218.78 |
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 $117.49 Median $173.78 Typical High $676.08 | Professional | None | $117.49 | $173.78 | $676.08 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $1,698.24 Typical High $6,456.54 | Facility | None | $95.50 | $1,698.24 | $6,456.54 |
Blue Shield Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $275.42 | Professional | None | $107.15 | $154.88 | $275.42 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $141.25 Median $263.03 Typical High $354.81 | Professional | None | $141.25 | $263.03 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $2,691.53 | Facility | None | $446.68 | $741.31 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $316.23 | Professional | None | $138.04 | $204.17 | $316.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $288.40 | Professional | None | $125.89 | $186.21 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $223.87 Typical High $457.09 | Professional | None | $114.82 | $223.87 | $457.09 |
Lucent Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $288.40 | Professional | None | $173.78 | $173.78 | $288.40 |
Providence Setting Facility Modifier None Typical Low $169.82 Median $501.19 Typical High $2,398.83 | Facility | None | $169.82 | $501.19 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $316.23 | Professional | None | $134.90 | $204.17 | $316.23 |
Sutter Health Plus Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $691.83 | Professional | None | $446.68 | $446.68 | $691.83 |
United Setting Facility Modifier None Typical Low $123.03 Median $501.19 Typical High $3,090.30 | Facility | None | $123.03 | $501.19 | $3,090.30 |
United Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $363.08 | Professional | None | $109.65 | $177.83 | $363.08 |
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 $64.57 Median $67.61 Typical High $109.65 | Facility | 52 · Reduced service | $64.57 | $67.61 | $109.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.70 Median $27.54 Typical High $43.65 | Facility | 53 · Discontinued | $25.70 | $27.54 | $43.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $97.72 Median $102.33 Typical High $162.18 | Facility | 54 · Surgery only | $97.72 | $102.33 | $162.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $20.42 Typical High $32.36 | Facility | 55 · Aftercare only | $19.50 | $20.42 | $32.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.80 Typical High $21.88 | Facility | 56 · Pre-op care only | $12.88 | $13.80 | $21.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $87.10 Typical High $109.65 | Professional | 52 · Reduced service | $61.66 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $34.67 Typical High $43.65 | Professional | 53 · Discontinued | $24.55 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $131.83 Typical High $162.18 | Professional | 54 · Surgery only | $91.20 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.30 Typical High $32.36 | Professional | 55 · Aftercare only | $18.62 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $17.38 Typical High $21.88 | Professional | 56 · Pre-op care only | $12.30 | $17.38 | $21.88 |
Where California sits
The same service costs 10.1 times more in Oklahoma than in Delaware. 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
OK $3,525DE $348
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.