How much rates vary
Facilitymedian $490 · 10th to 90th $48 to $5,623Professionalmedian $51 · 10th to 90th $34 to $112
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 $54.95 Median $4,897.79 Typical High $15,135.61 | Facility | None | $54.95 | $4,897.79 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $50.12 Typical High $85.11 | Professional | None | $33.88 | $50.12 | $85.11 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $53.70 Typical High $53.70 | Professional | None | $45.71 | $53.70 | $53.70 |
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 $42.66 Median $60.26 Typical High $102.33 | Professional | None | $42.66 | $60.26 | $102.33 |
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 $26.30 Median $43.65 Typical High $72.44 | Professional | None | $26.30 | $43.65 | $72.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $38.02 Median $58.88 Typical High $72.44 | Professional | None | $38.02 | $58.88 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $60.26 Typical High $758.58 | Facility | None | $38.02 | $60.26 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $52.48 Typical High $85.11 | Professional | None | $33.88 | $52.48 | $85.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $70.79 | Professional | None | $41.69 | $52.48 | $70.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $56.23 Typical High $125.89 | Professional | None | $37.15 | $56.23 | $125.89 |
Lucent Health Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $645.65 | Professional | None | $562.34 | $645.65 | $645.65 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $74.13 | Professional | None | $44.67 | $44.67 | $74.13 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $38.90 Median $72.44 Typical High $2,570.40 | Facility | None | $38.90 | $72.44 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $33.88 Median $52.48 Typical High $81.28 | Professional | None | $33.88 | $52.48 | $81.28 |
Sutter Health Plus Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $181.97 | Professional | None | $125.89 | $125.89 | $181.97 |
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 $30.90 Median $47.86 Typical High $85.11 | Professional | None | $30.90 | $47.86 | $85.11 |
12 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 $16.98 Median $17.78 Typical High $27.54 | Facility | 52 · Reduced service | $16.98 | $17.78 | $27.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.76 Median $7.08 Typical High $10.96 | Facility | 53 · Discontinued | $6.76 | $7.08 | $10.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $25.12 Median $26.92 Typical High $40.74 | Facility | 54 · Surgery only | $25.12 | $26.92 | $40.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.01 Median $5.37 Typical High $8.13 | Facility | 55 · Aftercare only | $5.01 | $5.37 | $8.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.55 Typical High $5.50 | Facility | 56 · Pre-op care only | $3.39 | $3.55 | $5.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $21.88 Typical High $27.54 | Professional | 52 · Reduced service | $16.22 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $8.71 Typical High $10.96 | Professional | 53 · Discontinued | $6.46 | $8.71 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $33.11 Typical High $40.74 | Professional | 54 · Surgery only | $23.99 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.61 Typical High $8.13 | Professional | 55 · Aftercare only | $4.79 | $6.61 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.37 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.24 | $4.37 | $5.50 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 59 · Distinct service | $48.98 | $48.98 | $48.98 |
Ambetter Setting Professional Modifier GA · Liability notice issued Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | GA · Liability notice issued | $53.70 | $53.70 | $53.70 |
Where California sits
The same service costs 4.2 times more in Alaska than in New York. 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· 37th of 51
$53.70
AK $186NY $44.67
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.