How much rates vary
Facilitymedian $2,042 · 10th to 90th $129 to $8,128Professionalmedian $126 · 10th to 90th $95 to $339
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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $128.82 | Professional | None | $102.33 | $112.20 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $10,000.00 | Facility | None | $2,137.96 | $4,786.30 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $141.25 Typical High $234.42 | Professional | None | $134.90 | $141.25 | $234.42 |
Blue Shield Setting Facility Modifier None Typical Low $66.07 Median $3,162.28 Typical High $6,606.93 | Facility | None | $66.07 | $3,162.28 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $144.54 | Professional | None | $72.44 | $107.15 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $912.01 Typical High $7,079.46 | Facility | None | $630.96 | $912.01 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $181.97 | Professional | None | $97.72 | $123.03 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $741.31 Typical High $1,288.25 | Professional | None | $467.74 | $741.31 | $1,288.25 |
Lucent Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
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 $151.36 Median $794.33 Typical High $7,079.46 | Facility | None | $151.36 | $794.33 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $181.97 | Professional | None | $97.72 | $123.03 | $181.97 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,090.30 | Facility | None | $123.03 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $194.98 | Professional | None | $93.33 | $117.49 | $194.98 |
5 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 Professional Modifier 52 · Reduced service Typical Low $52.48 Median $56.23 Typical High $60.26 | Professional | 52 · Reduced service | $52.48 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.39 Typical High $23.99 | Professional | 53 · Discontinued | $20.89 | $22.39 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $83.18 Typical High $89.13 | Professional | 54 · Surgery only | $79.43 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.98 Typical High $17.78 | Professional | 55 · Aftercare only | $15.85 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.22 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.47 | $11.22 | $12.02 |
Where California sits
The same service costs 4.0 times more in Alaska than in Delaware. 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
$129
AK $468DE $117
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.