How much rates vary
Facilitymedian $457 · 10th to 90th $76 to $5,623Professionalmedian $78 · 10th to 90th $54 to $186
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 $354.81 Median $5,128.61 Typical High $15,135.61 | Facility | None | $354.81 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $131.83 | Professional | None | $52.48 | $69.18 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $501.19 Typical High $501.19 | Professional | None | $190.55 | $501.19 | $501.19 |
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 $70.79 Median $93.33 Typical High $165.96 | Professional | None | $70.79 | $93.33 | $165.96 |
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 $43.65 Median $63.10 Typical High $97.72 | Professional | None | $43.65 | $63.10 | $97.72 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $58.88 Median $74.13 Typical High $128.82 | Professional | None | $58.88 | $74.13 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $97.72 Typical High $691.83 | Facility | None | $63.10 | $97.72 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $83.18 Typical High $131.83 | Professional | None | $61.66 | $83.18 | $131.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $48.98 Median $72.44 Typical High $128.82 | Professional | None | $48.98 | $72.44 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $102.33 Typical High $204.17 | Professional | None | $60.26 | $102.33 | $204.17 |
Lucent Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $812.83 | Professional | None | $630.96 | $630.96 | $812.83 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $125.89 | Professional | None | $74.13 | $74.13 | $125.89 |
Providence Setting Facility Modifier None Typical Low $63.10 Median $97.72 Typical High $676.08 | Facility | None | $63.10 | $97.72 | $676.08 |
Providence Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $131.83 | Professional | None | $61.66 | $81.28 | $131.83 |
Sutter Health Plus Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $275.42 | Professional | None | $213.80 | $213.80 | $275.42 |
United Setting Facility Modifier None Typical Low $123.03 Median $501.19 Typical High $3,090.30 | Facility | None | $123.03 | $501.19 | $3,090.30 |
United Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $141.25 | Professional | None | $53.70 | $75.86 | $141.25 |
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 $26.30 Median $28.18 Typical High $38.02 | Facility | 52 · Reduced service | $26.30 | $28.18 | $38.02 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.47 Median $11.48 Typical High $15.14 | Facility | 53 · Discontinued | $10.47 | $11.48 | $15.14 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.94 Median $8.51 Typical High $11.48 | Facility | 55 · Aftercare only | $7.94 | $8.51 | $11.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.75 Typical High $7.59 | Facility | 56 · Pre-op care only | $5.25 | $5.75 | $7.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $31.62 Typical High $38.02 | Professional | 52 · Reduced service | $26.30 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $12.59 Typical High $15.14 | Professional | 53 · Discontinued | $10.47 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $47.86 Typical High $56.23 | Professional | 54 · Surgery only | $39.81 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $9.55 Typical High $11.48 | Professional | 55 · Aftercare only | $7.94 | $9.55 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.31 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.25 | $6.31 | $7.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $117.49 Typical High $213.80 | Professional | 50 · Both sides | $93.33 | $117.49 | $213.80 |
Where California sits
The same service costs 3.8 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· 45th of 51
$79.43
AK $263KY $69.18
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.