How much rates vary
Facilitymedian $3,020 · 10th to 90th $708 to $12,023Professionalmedian $224 · 10th to 90th $129 to $1,288
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 $741.31 Median $6,606.93 Typical High $15,848.93 | Facility | None | $741.31 | $6,606.93 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $245.47 | Professional | None | $120.23 | $194.98 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,128.31 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $741.31 | Professional | None | $128.82 | $223.87 | $741.31 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,737.80 Typical High $11,220.18 | Facility | None | $100.00 | $1,737.80 | $11,220.18 |
Blue Shield Setting Professional Modifier None Typical Low $95.50 Median $165.96 Typical High $380.19 | Professional | None | $95.50 | $165.96 | $380.19 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $158.49 Median $323.59 Typical High $416.87 | Professional | None | $158.49 | $323.59 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,454.71 Typical High $5,011.87 | Facility | None | $758.58 | $2,454.71 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $489.78 | Professional | None | $138.04 | $229.09 | $489.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $141.25 Median $257.04 Typical High $416.87 | Professional | None | $141.25 | $257.04 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $309.03 Typical High $575.44 | Professional | None | $131.83 | $309.03 | $575.44 |
Lucent Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,511.89 | Professional | None | $2,137.96 | $2,137.96 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $380.19 | Professional | None | $229.09 | $229.09 | $380.19 |
Providence Setting Facility Modifier None Typical Low $295.12 Median $2,290.87 Typical High $4,466.84 | Facility | None | $295.12 | $2,290.87 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $501.19 | Professional | None | $138.04 | $208.93 | $501.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $954.99 | Professional | None | $467.74 | $467.74 | $954.99 |
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 $117.49 Median $234.42 Typical High $630.96 | Professional | None | $117.49 | $234.42 | $630.96 |
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 $60.26 Median $63.10 Typical High $123.03 | Facility | 52 · Reduced service | $60.26 | $63.10 | $123.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $25.12 Typical High $48.98 | Facility | 53 · Discontinued | $23.99 | $25.12 | $48.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.20 Median $18.62 Typical High $37.15 | Facility | 55 · Aftercare only | $18.20 | $18.62 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $24.55 | Facility | 56 · Pre-op care only | $12.02 | $12.59 | $24.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $97.72 Typical High $123.03 | Professional | 52 · Reduced service | $60.26 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $38.90 Typical High $48.98 | Professional | 53 · Discontinued | $23.99 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $147.91 Typical High $181.97 | Professional | 54 · Surgery only | $91.20 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $29.51 Typical High $37.15 | Professional | 55 · Aftercare only | $18.20 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $19.50 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.02 | $19.50 | $24.55 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $380.19 Typical High $562.34 | Professional | 50 · Both sides | $208.93 | $380.19 | $562.34 |
Where California sits
The same service costs 5.8 times more in Alaska than in Hawaii. 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
$251
AK $955HI $166
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.