How much rates vary
Facilitymedian $676 · 10th to 90th $72 to $6,457Professionalmedian $65 · 10th to 90th $32 to $224
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 $79.43 Median $4,570.88 Typical High $15,135.61 | Facility | None | $79.43 | $4,570.88 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $64.57 Typical High $125.89 | Professional | None | $32.36 | $64.57 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $97.72 | Professional | None | $89.13 | $89.13 | $97.72 |
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 $30.90 Median $64.57 Typical High $173.78 | Professional | None | $30.90 | $64.57 | $173.78 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $1,479.11 | Facility | None | $97.72 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $25.12 Median $50.12 Typical High $89.13 | Professional | None | $25.12 | $50.12 | $89.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $30.20 Median $47.86 Typical High $134.90 | Professional | None | $30.20 | $47.86 | $134.90 |
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 $35.48 Median $69.18 Typical High $125.89 | Professional | None | $35.48 | $69.18 | $125.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $19.95 Median $46.77 Typical High $131.83 | Professional | None | $19.95 | $46.77 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $97.72 Typical High $186.21 | Professional | None | $38.02 | $97.72 | $186.21 |
Lucent Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $776.25 | Professional | None | $602.56 | $602.56 | $776.25 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $120.23 | Professional | None | $72.44 | $72.44 | $120.23 |
Providence Setting Facility Modifier None Typical Low $43.65 Median $66.07 Typical High $676.08 | Facility | None | $43.65 | $66.07 | $676.08 |
Providence Setting Professional Modifier None Typical Low $35.48 Median $69.18 Typical High $114.82 | Professional | None | $35.48 | $69.18 | $114.82 |
Sutter Health Plus Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $281.84 | Professional | None | $120.23 | $120.23 | $281.84 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $28.84 Median $66.07 Typical High $151.36 | Professional | None | $28.84 | $66.07 | $151.36 |
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 $16.22 Median $17.38 Typical High $39.81 | Facility | 52 · Reduced service | $16.22 | $17.38 | $39.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.46 Median $6.92 Typical High $16.22 | Facility | 53 · Discontinued | $6.46 | $6.92 | $16.22 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $24.55 Median $26.30 Typical High $60.26 | Facility | 54 · Surgery only | $24.55 | $26.30 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.90 Median $5.25 Typical High $12.02 | Facility | 55 · Aftercare only | $4.90 | $5.25 | $12.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.47 Typical High $7.94 | Facility | 56 · Pre-op care only | $3.24 | $3.47 | $7.94 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $28.18 Typical High $36.31 | Professional | 52 · Reduced service | $15.85 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $11.22 Typical High $14.45 | Professional | 53 · Discontinued | $6.46 | $11.22 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $41.69 Typical High $54.95 | Professional | 54 · Surgery only | $23.99 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $8.71 Typical High $10.96 | Professional | 55 · Aftercare only | $4.79 | $8.71 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $5.89 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.16 | $5.89 | $7.24 |
Where California sits
The same service costs 3.7 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.
California· 43rd of 51
$69.18
AK $178KY $47.86
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.