How much rates vary
Facilitymedian $1,148 · 10th to 90th $100 to $6,457Professionalmedian $30 · 10th to 90th $20 to $126
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 $20.89 Median $29.51 Typical High $56.23 | Professional | None | $20.89 | $29.51 | $56.23 |
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 $19.95 Median $28.84 Typical High $77.62 | Professional | None | $19.95 | $28.84 | $77.62 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $1,047.13 Typical High $2,137.96 | Facility | None | $95.50 | $1,047.13 | $2,137.96 |
Blue Shield Setting Professional Modifier None Typical Low $18.20 Median $26.30 Typical High $47.86 | Professional | None | $18.20 | $26.30 | $47.86 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $21.88 Median $33.88 Typical High $44.67 | Professional | None | $21.88 | $33.88 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $831.76 Typical High $2,691.53 | Facility | None | $588.84 | $831.76 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $33.88 Typical High $52.48 | Professional | None | $24.55 | $33.88 | $52.48 |
Contra Costa Health Setting Professional Modifier None Typical Low $20.42 Median $25.70 Typical High $43.65 | Professional | None | $20.42 | $25.70 | $43.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.88 Median $36.31 Typical High $66.07 | Professional | None | $21.88 | $36.31 | $66.07 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,691.53 | $2,818.38 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $46.77 | Professional | None | $27.54 | $27.54 | $46.77 |
Providence Setting Facility Modifier None Typical Low $28.84 Median $630.96 Typical High $2,691.53 | Facility | None | $28.84 | $630.96 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $24.55 Median $33.88 Typical High $52.48 | Professional | None | $24.55 | $33.88 | $52.48 |
Sutter Health Plus Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $109.65 | Professional | None | $83.18 | $83.18 | $109.65 |
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 $20.42 Median $31.62 Typical High $57.54 | Professional | None | $20.42 | $31.62 | $57.54 |
9 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 $10.72 Median $11.22 Typical High $16.22 | Facility | 52 · Reduced service | $10.72 | $11.22 | $16.22 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.27 Median $4.47 Typical High $6.46 | Facility | 53 · Discontinued | $4.27 | $4.47 | $6.46 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.16 Median $3.31 Typical High $4.79 | Facility | 55 · Aftercare only | $3.16 | $3.31 | $4.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.24 Typical High $3.24 | Facility | 56 · Pre-op care only | $2.14 | $2.24 | $3.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.72 Median $13.80 Typical High $14.79 | Professional | 52 · Reduced service | $10.72 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $5.50 Typical High $5.89 | Professional | 53 · Discontinued | $4.27 | $5.50 | $5.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.85 Median $20.42 Typical High $22.39 | Professional | 54 · Surgery only | $15.85 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $4.07 Typical High $4.47 | Professional | 55 · Aftercare only | $3.16 | $4.07 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.75 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.14 | $2.75 | $2.95 |
Where California sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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
$32.36
AK $100NJ $28.84
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.