How much rates vary
Facilitymedian $3,548 · 10th to 90th $240 to $10,965Professionalmedian $151 · 10th to 90th $69 to $363
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 $478.63 Median $5,128.61 Typical High $15,135.61 | Facility | None | $478.63 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $134.90 Typical High $229.09 | Professional | None | $69.18 | $134.90 | $229.09 |
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 $79.43 Median $158.49 Typical High $288.40 | Professional | None | $79.43 | $158.49 | $288.40 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $57.54 Median $125.89 Typical High $245.47 | Professional | None | $57.54 | $125.89 | $245.47 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $77.62 Median $229.09 Typical High $338.84 | Professional | None | $77.62 | $229.09 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $158.49 Typical High $269.15 | Professional | None | $77.62 | $158.49 | $269.15 |
Contra Costa Health Setting Professional Modifier None Typical Low $69.18 Median $194.98 Typical High $245.47 | Professional | None | $69.18 | $194.98 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $151.36 Typical High $281.84 | Professional | None | $63.10 | $151.36 | $281.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $138.04 Typical High $229.09 | Professional | None | $33.11 | $138.04 | $229.09 |
Providence Setting Facility Modifier None Typical Low $69.18 Median $154.88 Typical High $338.84 | Facility | None | $69.18 | $154.88 | $338.84 |
Providence Setting Professional Modifier None Typical Low $77.62 Median $158.49 Typical High $269.15 | Professional | None | $77.62 | $158.49 | $269.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $562.34 | Professional | None | $251.19 | $251.19 | $562.34 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $7,244.36 | Facility | None | $602.56 | $1,698.24 | $7,244.36 |
United Setting Professional Modifier None Typical Low $64.57 Median $141.25 Typical High $295.12 | Professional | None | $64.57 | $141.25 | $295.12 |
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 $34.67 Median $36.31 Typical High $85.11 | Facility | 52 · Reduced service | $34.67 | $36.31 | $85.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.80 Median $14.45 Typical High $33.88 | Facility | 53 · Discontinued | $13.80 | $14.45 | $33.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $25.12 | Facility | 55 · Aftercare only | $10.47 | $10.72 | $25.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.24 Typical High $16.98 | Facility | 56 · Pre-op care only | $6.92 | $7.24 | $16.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $64.57 Typical High $85.11 | Professional | 52 · Reduced service | $33.11 | $64.57 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $25.70 Typical High $33.88 | Professional | 53 · Discontinued | $13.49 | $25.70 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $97.72 Typical High $125.89 | Professional | 54 · Surgery only | $50.12 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $19.50 Typical High $25.12 | Professional | 55 · Aftercare only | $10.00 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $12.88 Typical High $16.98 | Professional | 56 · Pre-op care only | $6.61 | $12.88 | $16.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $213.80 Typical High $371.54 | Professional | 50 · Both sides | $112.20 | $213.80 | $371.54 |
Where California sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 32nd of 51
$155
WI $309UT $120
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.