How much rates vary
Facilitymedian $3,467 · 10th to 90th $372 to $10,965Professionalmedian $204 · 10th to 90th $74 to $1,202
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 $72.44 Median $199.53 Typical High $398.11 | Professional | None | $72.44 | $199.53 | $398.11 |
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 $95.50 Median $102.33 Typical High $549.54 | Professional | None | $95.50 | $102.33 | $549.54 |
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 $57.54 Median $147.91 Typical High $295.12 | Professional | None | $57.54 | $147.91 | $295.12 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $85.11 Median $354.81 Typical High $489.78 | Professional | None | $85.11 | $354.81 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $229.09 Typical High $478.63 | Professional | None | $81.28 | $229.09 | $478.63 |
Contra Costa Health Setting Professional Modifier None Typical Low $75.86 Median $208.93 Typical High $478.63 | Professional | None | $75.86 | $208.93 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $302.00 Typical High $562.34 | Professional | None | $69.18 | $302.00 | $562.34 |
Lucent Health Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $251.19 Typical High $416.87 | Professional | None | $33.11 | $251.19 | $416.87 |
Providence Setting Facility Modifier None Typical Low $85.11 Median $229.09 Typical High $489.78 | Facility | None | $85.11 | $229.09 | $489.78 |
Providence Setting Professional Modifier None Typical Low $81.28 Median $223.87 Typical High $489.78 | Professional | None | $81.28 | $223.87 | $489.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $977.24 | Professional | None | $269.15 | $269.15 | $977.24 |
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 $70.79 Median $229.09 Typical High $537.03 | Professional | None | $70.79 | $229.09 | $537.03 |
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 $37.15 Median $38.90 Typical High $128.82 | Facility | 52 · Reduced service | $37.15 | $38.90 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $15.85 Typical High $52.48 | Facility | 53 · Discontinued | $14.79 | $15.85 | $52.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $11.75 Typical High $38.90 | Facility | 55 · Aftercare only | $11.22 | $11.75 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.76 Typical High $25.70 | Facility | 56 · Pre-op care only | $7.41 | $7.76 | $25.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $97.72 Typical High $128.82 | Professional | 52 · Reduced service | $37.15 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $38.90 Typical High $52.48 | Professional | 53 · Discontinued | $14.79 | $38.90 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $147.91 Typical High $194.98 | Professional | 54 · Surgery only | $56.23 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $29.51 Typical High $38.90 | Professional | 55 · Aftercare only | $11.22 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $19.50 Typical High $25.70 | Professional | 56 · Pre-op care only | $7.41 | $19.50 | $25.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $269.15 Typical High $371.54 | Professional | 50 · Both sides | $123.03 | $269.15 | $371.54 |
Where California sits
The same service costs 4.2 times more in Washington 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· 38th of 51
$209
WA $447VA $107
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.