How much rates vary
Facilitymedian $1,148 · 10th to 90th $214 to $6,761Professionalmedian $275 · 10th to 90th $182 to $1,738
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 $741.31 Median $6,606.93 Typical High $15,848.93 | Facility | None | $741.31 | $6,606.93 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $288.40 | Professional | None | $190.55 | $234.42 | $288.40 |
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 $181.97 Median $245.47 Typical High $870.96 | Professional | None | $181.97 | $245.47 | $870.96 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,148.15 Typical High $7,079.46 | Facility | None | $100.00 | $1,148.15 | $7,079.46 |
Blue Shield Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $446.68 | Professional | None | $158.49 | $245.47 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $478.63 Typical High $1,148.15 | Facility | None | $302.00 | $478.63 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $512.86 | Professional | None | $213.80 | $295.12 | $512.86 |
Contra Costa Health Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $549.54 | Professional | None | $251.19 | $338.84 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $436.52 Typical High $776.25 | Professional | None | $229.09 | $436.52 | $776.25 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,467.37 | Professional | None | $2,691.53 | $2,691.53 | $3,467.37 |
Providence Setting Facility Modifier None Typical Low $275.42 Median $524.81 Typical High $3,890.45 | Facility | None | $275.42 | $524.81 | $3,890.45 |
Providence Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $512.86 | Professional | None | $213.80 | $295.12 | $512.86 |
Sutter Health Plus Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,230.27 | Professional | None | $831.76 | $831.76 | $1,230.27 |
United Setting Facility Modifier None Typical Low $147.91 Median $1,148.15 Typical High $1,737.80 | Facility | None | $147.91 | $1,148.15 | $1,737.80 |
United Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $660.69 | Professional | None | $199.53 | $302.00 | $660.69 |
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 $95.50 Median $100.00 Typical High $141.25 | Facility | 52 · Reduced service | $95.50 | $100.00 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.02 Median $39.81 Typical High $57.54 | Facility | 53 · Discontinued | $38.02 | $39.81 | $57.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $141.25 Median $147.91 Typical High $213.80 | Facility | 54 · Surgery only | $141.25 | $147.91 | $213.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.18 Median $29.51 Typical High $42.66 | Facility | 55 · Aftercare only | $28.18 | $29.51 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.95 Typical High $28.84 | Facility | 56 · Pre-op care only | $19.05 | $19.95 | $28.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $117.49 Typical High $141.25 | Professional | 52 · Reduced service | $95.50 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $46.77 Typical High $57.54 | Professional | 53 · Discontinued | $38.02 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $177.83 Typical High $213.80 | Professional | 54 · Surgery only | $141.25 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $35.48 Typical High $42.66 | Professional | 55 · Aftercare only | $28.18 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.44 Typical High $28.84 | Professional | 56 · Pre-op care only | $19.05 | $23.44 | $28.84 |
Where California sits
The same service costs 4.0 times more in Alaska than in New York. 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· 44th of 51
$302
AK $1,023NY $257
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.