How much rates vary
Facilitymedian $537 · 10th to 90th $65 to $7,586Professionalmedian $68 · 10th to 90th $44 to $145
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 $74.13 Median $3,890.45 Typical High $13,803.84 | Facility | None | $74.13 | $3,890.45 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $69.18 Typical High $104.71 | Professional | None | $43.65 | $69.18 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $67.61 Typical High $79.43 | Professional | None | $38.90 | $67.61 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $7,943.28 Typical High $16,982.44 | Facility | None | $3,630.78 | $7,943.28 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $87.10 Typical High $138.04 | Professional | None | $57.54 | $87.10 | $138.04 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $426.58 Typical High $1,479.11 | Facility | None | $100.00 | $426.58 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $38.02 Median $57.54 Typical High $93.33 | Professional | None | $38.02 | $57.54 | $93.33 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $39.81 Median $69.18 Typical High $95.50 | Professional | None | $39.81 | $69.18 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $83.18 Typical High $758.58 | Facility | None | $52.48 | $83.18 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $61.66 Typical High $97.72 | Professional | None | $45.71 | $61.66 | $97.72 |
Contra Costa Health Setting Professional Modifier None Typical Low $43.65 Median $52.48 Typical High $93.33 | Professional | None | $43.65 | $52.48 | $93.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $40.74 Median $72.44 Typical High $141.25 | Professional | None | $40.74 | $72.44 | $141.25 |
Lucent Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $588.84 | Professional | None | $478.63 | $478.63 | $588.84 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $93.33 | Professional | None | $56.23 | $56.23 | $93.33 |
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 $51.29 Median $100.00 Typical High $2,570.40 | Facility | None | $51.29 | $100.00 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $97.72 | Professional | None | $45.71 | $60.26 | $97.72 |
Sutter Health Plus Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Sutter Health Plus Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Professional | None | $147.91 | $147.91 | $204.17 |
United Setting Facility Modifier None Typical Low $125.89 Median $549.54 Typical High $3,090.30 | Facility | None | $125.89 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $37.15 Median $57.54 Typical High $102.33 | Professional | None | $37.15 | $57.54 | $102.33 |
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 $22.91 Median $23.99 Typical High $40.74 | Facility | 52 · Reduced service | $22.91 | $23.99 | $40.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.12 Median $9.77 Typical High $16.22 | Facility | 53 · Discontinued | $9.12 | $9.77 | $16.22 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $33.88 Median $36.31 Typical High $61.66 | Facility | 54 · Surgery only | $33.88 | $36.31 | $61.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.92 Median $7.24 Typical High $12.30 | Facility | 55 · Aftercare only | $6.92 | $7.24 | $12.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.79 Typical High $8.13 | Facility | 56 · Pre-op care only | $4.57 | $4.79 | $8.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $28.84 Typical High $37.15 | Professional | 52 · Reduced service | $21.38 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $11.75 Typical High $14.79 | Professional | 53 · Discontinued | $8.71 | $11.75 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $43.65 Typical High $54.95 | Professional | 54 · Surgery only | $32.36 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $8.71 Typical High $10.96 | Professional | 55 · Aftercare only | $6.46 | $8.71 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.89 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.37 | $5.89 | $7.41 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $95.50 Median $97.72 Typical High $112.20 | Professional | 50 · Both sides | $95.50 | $97.72 | $112.20 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $72.44 Median $97.72 Typical High $173.78 | Professional | 50 · Both sides | $72.44 | $97.72 | $173.78 |
Where California sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 31st of 51
$70.79
AK $224FL $53.70
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.