How much rates vary
Facilitymedian $661 · 10th to 90th $76 to $6,457Professionalmedian $39 · 10th to 90th $15 to $209
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 $45.71 Median $7,079.46 Typical High $18,197.01 | Facility | None | $45.71 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $25.70 Typical High $45.71 | Professional | None | $15.14 | $25.70 | $45.71 |
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 $14.79 Median $38.90 Typical High $87.10 | Professional | None | $14.79 | $38.90 | $87.10 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $416.87 Typical High $1,513.56 | Facility | None | $91.20 | $416.87 | $1,513.56 |
Blue Shield Setting Professional Modifier None Typical Low $14.45 Median $38.02 Typical High $67.61 | Professional | None | $14.45 | $38.02 | $67.61 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $12.59 Median $18.20 Typical High $44.67 | Professional | None | $12.59 | $18.20 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $1,202.26 Typical High $2,691.53 | Facility | None | $50.12 | $1,202.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $37.15 Typical High $64.57 | Professional | None | $16.98 | $37.15 | $64.57 |
Contra Costa Health Setting Professional Modifier None Typical Low $10.47 Median $17.78 Typical High $44.67 | Professional | None | $10.47 | $17.78 | $44.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $14.79 Median $33.11 Typical High $61.66 | Professional | None | $14.79 | $33.11 | $61.66 |
Lucent Health Setting Professional Modifier None Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | None | $302.00 | $309.03 | $309.03 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $44.67 | Professional | None | $26.30 | $26.30 | $44.67 |
Providence Setting Facility Modifier None Typical Low $17.78 Median $50.12 Typical High $2,691.53 | Facility | None | $17.78 | $50.12 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $16.98 Median $38.90 Typical High $64.57 | Professional | None | $16.98 | $38.90 | $64.57 |
Sutter Health Plus Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $134.90 | Professional | None | $57.54 | $57.54 | $134.90 |
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 $14.13 Median $30.90 Typical High $72.44 | Professional | None | $14.13 | $30.90 | $72.44 |
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 $7.76 Median $8.13 Typical High $25.12 | Facility | 52 · Reduced service | $7.76 | $8.13 | $25.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.16 Median $3.24 Typical High $10.23 | Facility | 53 · Discontinued | $3.16 | $3.24 | $10.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $11.75 Median $12.30 Typical High $38.02 | Facility | 54 · Surgery only | $11.75 | $12.30 | $38.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.34 Median $2.45 Typical High $7.59 | Facility | 55 · Aftercare only | $2.34 | $2.45 | $7.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.62 Typical High $5.13 | Facility | 56 · Pre-op care only | $1.55 | $1.62 | $5.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.41 Median $12.02 Typical High $22.91 | Professional | 52 · Reduced service | $7.41 | $12.02 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $4.79 Typical High $9.12 | Professional | 53 · Discontinued | $3.02 | $4.79 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.22 Median $18.20 Typical High $33.88 | Professional | 54 · Surgery only | $11.22 | $18.20 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $3.63 Typical High $6.92 | Professional | 55 · Aftercare only | $2.24 | $3.63 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $2.40 Typical High $4.57 | Professional | 56 · Pre-op care only | $1.51 | $2.40 | $4.57 |
Where California sits
The same service costs 3.9 times more in Alaska than in Hawaii. 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· 18th of 51
$41.69
AK $85.11HI $21.88
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.