How much rates vary
Facilitymedian $1,479 · 10th to 90th $78 to $6,918Professionalmedian $48 · 10th to 90th $38 to $575
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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $42.66 Typical High $60.26 | Professional | None | $38.90 | $42.66 | $60.26 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
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 $38.02 Median $40.74 Typical High $173.78 | Professional | None | $38.02 | $40.74 | $173.78 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $1,445.44 Typical High $4,897.79 | Facility | None | $91.20 | $1,445.44 | $4,897.79 |
Blue Shield Setting Professional Modifier None Typical Low $34.67 Median $50.12 Typical High $75.86 | Professional | None | $34.67 | $50.12 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $676.08 | Facility | None | $50.12 | $61.66 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $107.15 | Professional | None | $43.65 | $47.86 | $107.15 |
Contra Costa Health Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $50.12 | Professional | None | $41.69 | $45.71 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $35.48 Median $44.67 Typical High $112.20 | Professional | None | $35.48 | $44.67 | $112.20 |
Lucent Health Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $645.65 | Professional | None | $575.44 | $645.65 | $645.65 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Providence Setting Facility Modifier None Typical Low $46.77 Median $58.88 Typical High $676.08 | Facility | None | $46.77 | $58.88 | $676.08 |
Providence Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $100.00 | Professional | None | $43.65 | $47.86 | $100.00 |
Sutter Health Plus Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,090.30 | Facility | None | $123.03 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $87.10 | Professional | None | $36.31 | $45.71 | $87.10 |
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 $18.62 Median $20.42 Typical High $21.38 | Professional | 52 · Reduced service | $18.62 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.13 Typical High $8.51 | Professional | 53 · Discontinued | $7.41 | $8.13 | $8.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $30.90 Typical High $31.62 | Professional | 54 · Surgery only | $27.54 | $30.90 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.17 Typical High $6.31 | Professional | 55 · Aftercare only | $5.50 | $6.17 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.07 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.72 | $4.07 | $4.27 |
Where California sits
The same service costs 13.8 times more in Oklahoma 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· 40th of 51
$52.48
OK $575NY $41.69
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.