How much rates vary
Facilitymedian $3,467 · 10th to 90th $912 to $10,471Professionalmedian $302 · 10th to 90th $170 to $759
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 $660.69 Median $660.69 Typical High $758.58 | Professional | None | $660.69 | $660.69 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $6,606.93 Typical High $13,489.63 | Facility | None | $3,630.78 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $660.69 Typical High $1,230.27 | Professional | None | $199.53 | $660.69 | $1,230.27 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,737.80 Typical High $8,128.31 | Facility | None | $100.00 | $1,737.80 | $8,128.31 |
Blue Shield Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $331.13 | Professional | None | $169.82 | $245.47 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,884.03 Typical High $4,786.30 | Facility | None | $645.65 | $2,884.03 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $489.78 Typical High $1,096.48 | Professional | None | $190.55 | $489.78 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $5,248.07 | Professional | None | $1,584.89 | $2,187.76 | $5,248.07 |
Lucent Health Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $2,951.21 Typical High $5,888.44 | Facility | None | $707.95 | $2,951.21 | $5,888.44 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $588.84 | Professional | None | $60.26 | $79.43 | $588.84 |
Sutter Health Plus Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Facility | None | $5,128.61 | $5,128.61 | $5,128.61 |
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 $1,412.54 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,412.54 | $1,412.54 | $1,737.80 |
6 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 $331.13 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $251.19 Median $831.76 Typical High $1,148.15 | Professional | 50 · Both sides | $251.19 | $831.76 | $1,148.15 |
Where California sits
The same service costs 67.6 times more in Oklahoma than in Montana. 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· 35th of 51
$1,096
OK $5,370MT $79.43
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.