How much rates vary
Facilitymedian $933 · 10th to 90th $87 to $6,918Professionalmedian $129 · 10th to 90th $65 to $309
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 $204.17 Median $4,897.79 Typical High $15,135.61 | Facility | None | $204.17 | $4,897.79 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $162.18 Typical High $251.19 | Professional | None | $64.57 | $162.18 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $151.36 | Professional | None | $83.18 | $83.18 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $83.18 Typical High $416.87 | Professional | None | $74.13 | $83.18 | $416.87 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $724.44 Typical High $4,786.30 | Facility | None | $95.50 | $724.44 | $4,786.30 |
Blue Shield Setting Professional Modifier None Typical Low $48.98 Median $114.82 Typical High $204.17 | Professional | None | $48.98 | $114.82 | $204.17 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $77.62 Median $257.04 Typical High $501.19 | Professional | None | $77.62 | $257.04 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $5,623.41 | Facility | None | $50.12 | $61.66 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $154.88 Typical High $257.04 | Professional | None | $67.61 | $154.88 | $257.04 |
Contra Costa Health Setting Professional Modifier None Typical Low $85.11 Median $229.09 Typical High $309.03 | Professional | None | $85.11 | $229.09 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $186.21 Typical High $371.54 | Professional | None | $75.86 | $186.21 | $371.54 |
Lucent Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $229.09 | Professional | None | $138.04 | $138.04 | $229.09 |
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 $50.12 Median $100.00 Typical High $5,623.41 | Facility | None | $50.12 | $100.00 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $154.88 Typical High $257.04 | Professional | None | $67.61 | $154.88 | $257.04 |
Sutter Health Plus Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $537.03 | Professional | None | $275.42 | $275.42 | $537.03 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $3,090.30 | Facility | None | $123.03 | $537.03 | $3,090.30 |
United Setting Professional Modifier None Typical Low $64.57 Median $134.90 Typical High $275.42 | Professional | None | $64.57 | $134.90 | $275.42 |
12 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 $32.36 Median $33.88 Typical High $102.33 | Facility | 52 · Reduced service | $32.36 | $33.88 | $102.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.88 Median $13.49 Typical High $40.74 | Facility | 53 · Discontinued | $12.88 | $13.49 | $40.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $47.86 Median $51.29 Typical High $154.88 | Facility | 54 · Surgery only | $47.86 | $51.29 | $154.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $10.23 Typical High $30.90 | Facility | 55 · Aftercare only | $9.55 | $10.23 | $30.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.76 Typical High $20.42 | Facility | 56 · Pre-op care only | $6.46 | $6.76 | $20.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $67.61 Typical High $91.20 | Professional | 52 · Reduced service | $30.90 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $26.92 Typical High $36.31 | Professional | 53 · Discontinued | $12.30 | $26.92 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $102.33 Typical High $138.04 | Professional | 54 · Surgery only | $46.77 | $102.33 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $20.42 Typical High $27.54 | Professional | 55 · Aftercare only | $9.33 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $13.49 Typical High $18.20 | Professional | 56 · Pre-op care only | $6.17 | $13.49 | $18.20 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $114.82 Typical High $281.84 | Professional | 50 · Both sides | $114.82 | $114.82 | $281.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $162.18 Typical High $223.87 | Professional | 50 · Both sides | $131.83 | $162.18 | $223.87 |
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· 46th of 51
$132
AK $417VA $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.