How much rates vary
Facilitymedian $2,570 · 10th to 90th $42 to $10,000Professionalmedian $126 · 10th to 90th $47 to $617
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 $165.96 Median $4,897.79 Typical High $15,135.61 | Facility | None | $165.96 | $4,897.79 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $128.82 Typical High $223.87 | Professional | None | $44.67 | $128.82 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $147.91 Typical High $234.42 | Professional | None | $45.71 | $147.91 | $234.42 |
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 $60.26 Median $66.07 Typical High $338.84 | Professional | None | $60.26 | $66.07 | $338.84 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $37.15 Median $97.72 Typical High $190.55 | Professional | None | $37.15 | $97.72 | $190.55 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $51.29 Median $218.78 Typical High $295.12 | Professional | None | $51.29 | $218.78 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $134.90 Typical High $288.40 | Professional | None | $51.29 | $134.90 | $288.40 |
Contra Costa Health Setting Professional Modifier None Typical Low $45.71 Median $173.78 Typical High $229.09 | Professional | None | $45.71 | $173.78 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $134.90 Typical High $281.84 | Professional | None | $41.69 | $134.90 | $281.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,548.82 | $1,548.82 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $131.83 Typical High $223.87 | Professional | None | $33.11 | $131.83 | $223.87 |
Providence Setting Facility Modifier None Typical Low $48.98 Median $147.91 Typical High $316.23 | Facility | None | $48.98 | $147.91 | $316.23 |
Providence Setting Professional Modifier None Typical Low $51.29 Median $134.90 Typical High $295.12 | Professional | None | $51.29 | $134.90 | $295.12 |
Sutter Health Plus Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $512.86 | Professional | None | $165.96 | $165.96 | $512.86 |
United Setting Facility Modifier None Typical Low $41.69 Median $549.54 Typical High $3,981.07 | Facility | None | $41.69 | $549.54 | $3,981.07 |
United Setting Professional Modifier None Typical Low $43.65 Median $125.89 Typical High $275.42 | Professional | None | $43.65 | $125.89 | $275.42 |
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 $23.44 Median $24.55 Typical High $83.18 | Facility | 52 · Reduced service | $23.44 | $24.55 | $83.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.33 Median $9.77 Typical High $33.11 | Facility | 53 · Discontinued | $9.33 | $9.77 | $33.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.08 Median $7.41 Typical High $25.12 | Facility | 55 · Aftercare only | $7.08 | $7.41 | $25.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.90 Typical High $16.60 | Facility | 56 · Pre-op care only | $4.68 | $4.90 | $16.60 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $52.48 Typical High $83.18 | Professional | 52 · Reduced service | $22.91 | $52.48 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $20.89 Typical High $33.11 | Professional | 53 · Discontinued | $9.12 | $20.89 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $77.62 Typical High $125.89 | Professional | 54 · Surgery only | $34.67 | $77.62 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $15.85 Typical High $25.12 | Professional | 55 · Aftercare only | $6.92 | $15.85 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $10.47 Typical High $16.60 | Professional | 56 · Pre-op care only | $4.57 | $10.47 | $16.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $77.62 Median $147.91 Typical High $190.55 | Professional | 50 · Both sides | $77.62 | $147.91 | $190.55 |
Where California sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 36th of 51
$129
AK $257VA $66.07
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.