How much rates vary
Facilitymedian $589 · 10th to 90th $89 to $2,951Professionalmedian $79 · 10th to 90th $59 to $676
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 $912.01 Median $8,128.31 Typical High $19,054.61 | Facility | None | $912.01 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $72.44 | Professional | None | $61.66 | $67.61 | $72.44 |
Ambetter Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $4,786.30 Typical High $6,606.93 | Facility | None | $3,235.94 | $4,786.30 | $6,606.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $123.03 Typical High $371.54 | Professional | None | $61.66 | $123.03 | $371.54 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $1,548.82 | Facility | None | $97.72 | $416.87 | $1,548.82 |
Blue Shield Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $109.65 | Professional | None | $53.70 | $77.62 | $109.65 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $22.39 Median $33.88 Typical High $38.02 | Professional | None | $22.39 | $33.88 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $645.65 Typical High $1,096.48 | Facility | None | $53.70 | $645.65 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $120.23 | Professional | None | $69.18 | $75.86 | $120.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $93.33 Typical High $346.74 | Professional | None | $54.95 | $93.33 | $346.74 |
Lucent Health Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $676.08 | Professional | None | $575.44 | $575.44 | $676.08 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $630.96 Typical High $1,047.13 | Facility | None | $56.23 | $630.96 | $1,047.13 |
Providence Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $120.23 | Professional | None | $69.18 | $75.86 | $120.23 |
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 $58.88 Median $72.44 Typical High $147.91 | Professional | None | $58.88 | $72.44 | $147.91 |
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 $30.20 Median $33.88 Typical High $36.31 | Professional | 52 · Reduced service | $30.20 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.80 Typical High $14.45 | Professional | 53 · Discontinued | $12.02 | $13.80 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $51.29 Typical High $53.70 | Professional | 54 · Surgery only | $45.71 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.23 Typical High $10.72 | Professional | 55 · Aftercare only | $9.12 | $10.23 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.76 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.03 | $6.76 | $7.24 |
Where California sits
The same service costs 5.5 times more in Arkansas 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· 25th of 51
$100
AR $331KY $60.26
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.