How much rates vary
Facilitymedian $3,467 · 10th to 90th $288 to $10,965Professionalmedian $145 · 10th to 90th $68 to $1,175
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 $363.08 Median $5,128.61 Typical High $15,135.61 | Facility | None | $363.08 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $141.25 Typical High $213.80 | Professional | None | $66.07 | $141.25 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $102.33 Typical High $436.52 | Professional | None | $63.10 | $102.33 | $436.52 |
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 $79.43 Median $93.33 Typical High $380.19 | Professional | None | $79.43 | $93.33 | $380.19 |
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 $54.95 Median $123.03 Typical High $229.09 | Professional | None | $54.95 | $123.03 | $229.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $74.13 Median $234.42 Typical High $323.59 | Professional | None | $74.13 | $234.42 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $162.18 Typical High $316.23 | Professional | None | $74.13 | $162.18 | $316.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $67.61 Median $181.97 Typical High $269.15 | Professional | None | $67.61 | $181.97 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $177.83 Typical High $354.81 | Professional | None | $61.66 | $177.83 | $354.81 |
Lucent Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,698.24 | $1,698.24 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $162.18 Typical High $269.15 | Professional | None | $33.11 | $162.18 | $269.15 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $169.82 Typical High $416.87 | Facility | None | $72.44 | $169.82 | $416.87 |
Providence Setting Professional Modifier None Typical Low $74.13 Median $162.18 Typical High $323.59 | Professional | None | $74.13 | $162.18 | $323.59 |
Sutter Health Plus Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $616.60 | Professional | None | $245.47 | $245.47 | $616.60 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $7,244.36 | Facility | None | $602.56 | $1,698.24 | $7,244.36 |
United Setting Professional Modifier None Typical Low $63.10 Median $151.36 Typical High $338.84 | Professional | None | $63.10 | $151.36 | $338.84 |
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 $33.88 Median $36.31 Typical High $89.13 | Facility | 52 · Reduced service | $33.88 | $36.31 | $89.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.80 Median $14.45 Typical High $35.48 | Facility | 53 · Discontinued | $13.80 | $14.45 | $35.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.23 Median $10.72 Typical High $26.92 | Facility | 55 · Aftercare only | $10.23 | $10.72 | $26.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.24 Typical High $17.78 | Facility | 56 · Pre-op care only | $6.76 | $7.24 | $17.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $66.07 Typical High $89.13 | Professional | 52 · Reduced service | $33.11 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $26.30 Typical High $35.48 | Professional | 53 · Discontinued | $13.49 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $97.72 Typical High $134.90 | Professional | 54 · Surgery only | $50.12 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $19.50 Typical High $26.92 | Professional | 55 · Aftercare only | $10.00 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $13.18 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.76 | $13.18 | $17.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $181.97 Typical High $223.87 | Professional | 50 · Both sides | $107.15 | $181.97 | $223.87 |
Where California sits
The same service costs 3.8 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· 39th of 51
$148
AK $363VA $95.50
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.