How much rates vary
Facilitymedian $417 · 10th to 90th $120 to $6,607Professionalmedian $234 · 10th to 90th $155 to $1,288
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 $251.19 Median $7,079.46 Typical High $18,197.01 | Facility | None | $251.19 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $275.42 | Professional | None | $151.36 | $218.78 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $602.56 | Professional | None | $177.83 | $181.97 | $602.56 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $1,479.11 | Facility | None | $97.72 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $316.23 | Professional | None | $144.54 | $208.93 | $316.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $194.98 Median $436.52 Typical High $524.81 | Professional | None | $194.98 | $436.52 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $245.47 Typical High $512.86 | Facility | None | $53.70 | $245.47 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $478.63 | Professional | None | $154.88 | $245.47 | $478.63 |
Contra Costa Health Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $524.81 | Professional | None | $213.80 | $309.03 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $389.05 Typical High $724.44 | Professional | None | $186.21 | $389.05 | $724.44 |
Lucent Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,162.28 | Professional | None | $2,398.83 | $2,398.83 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $457.09 | Professional | None | $275.42 | $275.42 | $457.09 |
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 $61.66 Median $251.19 Typical High $549.54 | Facility | None | $61.66 | $251.19 | $549.54 |
Providence Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $416.87 | Professional | None | $154.88 | $245.47 | $416.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,023.29 | Professional | None | $602.56 | $602.56 | $1,023.29 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $524.81 | Professional | None | $151.36 | $251.19 | $524.81 |
9 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 $81.28 Median $87.10 Typical High $138.04 | Facility | 52 · Reduced service | $81.28 | $87.10 | $138.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $32.36 Median $34.67 Typical High $56.23 | Facility | 53 · Discontinued | $32.36 | $34.67 | $56.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $25.70 Typical High $41.69 | Facility | 55 · Aftercare only | $23.99 | $25.70 | $41.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.38 Typical High $27.54 | Facility | 56 · Pre-op care only | $16.22 | $17.38 | $27.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $109.65 Typical High $138.04 | Professional | 52 · Reduced service | $75.86 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $43.65 Typical High $56.23 | Professional | 53 · Discontinued | $30.20 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $165.96 Typical High $208.93 | Professional | 54 · Surgery only | $114.82 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $33.11 Typical High $41.69 | Professional | 55 · Aftercare only | $22.91 | $33.11 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.88 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.14 | $21.88 | $27.54 |
Where California sits
The same service costs 3.8 times more in Alaska than in Maryland. 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· 44th of 51
$245
AK $759MD $200
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.