How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,000 to $11,482Professionalmedian $1,148 · 10th to 90th $912 to $7,413
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 $2,137.96 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,137.96 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,445.44 | Professional | None | $912.01 | $1,000.00 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,128.31 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $3,981.07 | Professional | None | $1,122.02 | $1,174.90 | $3,981.07 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,737.80 Typical High $7,762.47 | Facility | None | $100.00 | $1,737.80 | $7,762.47 |
Blue Shield Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $1,659.59 | Professional | None | $812.83 | $1,174.90 | $1,659.59 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,548.82 | Professional | None | $933.25 | $1,148.15 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,019.95 Typical High $5,754.40 | Facility | None | $758.58 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,174.90 | $1,778.28 |
Contra Costa Health Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,380.38 | Professional | None | $912.01 | $1,148.15 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $2,754.23 | Professional | None | $870.96 | $1,047.13 | $2,754.23 |
Lucent Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,762.47 Typical High $7,762.47 | Professional | None | $7,413.10 | $7,762.47 | $7,762.47 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $3,235.94 Typical High $10,000.00 | Facility | None | $870.96 | $3,235.94 | $10,000.00 |
Providence Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,174.90 | $1,819.70 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,365.16 | $14,454.40 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,995.26 | Professional | None | $812.83 | $1,071.52 | $1,995.26 |
5 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 Professional Modifier 52 · Reduced service Typical Low $446.68 Median $489.78 Typical High $501.19 | Professional | 52 · Reduced service | $446.68 | $489.78 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $194.98 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $724.44 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $724.44 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $144.54 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $97.72 Typical High $100.00 | Professional | 56 · Pre-op care only | $89.13 | $97.72 | $100.00 |
Where California sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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
AK $8,955KY $2,479
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.