How much rates vary
Facilitymedian $490 · 10th to 90th $66 to $6,607Professionalmedian $55 · 10th to 90th $38 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 $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 $38.02 Median $54.95 Typical High $95.50 | Professional | None | $38.02 | $54.95 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $79.43 | Professional | None | $64.57 | $64.57 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $60.26 Typical High $114.82 | Professional | None | $44.67 | $60.26 | $114.82 |
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 $34.67 Median $50.12 Typical High $77.62 | Professional | None | $34.67 | $50.12 | $77.62 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $43.65 Median $74.13 Typical High $95.50 | Professional | None | $43.65 | $74.13 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $91.20 Typical High $758.58 | Facility | None | $56.23 | $91.20 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $58.88 Typical High $95.50 | Professional | None | $41.69 | $58.88 | $95.50 |
Contra Costa Health Setting Professional Modifier None Typical Low $41.69 Median $54.95 Typical High $93.33 | Professional | None | $41.69 | $54.95 | $93.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $72.44 Typical High $138.04 | Professional | None | $38.02 | $72.44 | $138.04 |
Lucent Health Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $91.20 | Professional | None | $54.95 | $54.95 | $91.20 |
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 $54.95 Median $97.72 Typical High $2,570.40 | Facility | None | $54.95 | $97.72 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $89.13 | Professional | None | $40.74 | $57.54 | $89.13 |
Sutter Health Plus Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $204.17 | Professional | None | $134.90 | $134.90 | $204.17 |
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 $33.11 Median $52.48 Typical High $104.71 | Professional | None | $33.11 | $52.48 | $104.71 |
11 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 $19.05 Median $20.42 Typical High $30.20 | Facility | 52 · Reduced service | $19.05 | $20.42 | $30.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.59 Median $8.13 Typical High $12.02 | Facility | 53 · Discontinued | $7.59 | $8.13 | $12.02 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $28.84 Median $30.20 Typical High $44.67 | Facility | 54 · Surgery only | $28.84 | $30.20 | $44.67 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.75 Median $6.17 Typical High $8.91 | Facility | 55 · Aftercare only | $5.75 | $6.17 | $8.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.07 Typical High $6.03 | Facility | 56 · Pre-op care only | $3.80 | $4.07 | $6.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $23.99 Typical High $30.20 | Professional | 52 · Reduced service | $18.20 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $9.77 Typical High $12.02 | Professional | 53 · Discontinued | $7.24 | $9.77 | $12.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $36.31 Typical High $44.67 | Professional | 54 · Surgery only | $27.54 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $7.24 Typical High $8.91 | Professional | 55 · Aftercare only | $5.50 | $7.24 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.79 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.63 | $4.79 | $6.03 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 51 · Multiple procedures | $38.02 | $38.02 | $38.02 |
Where California sits
The same service costs 3.5 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· 47th of 51
$57.54
AK $178FL $51.29
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.