How much rates vary
Facilitymedian $5,012 · 10th to 90th $813 to $13,490Professionalmedian $2,138 · 10th to 90th $155 to $12,882
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 $2,630.27 Median $7,943.28 Typical High $20,892.96 | Facility | None | $2,630.27 | $7,943.28 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $2,570.40 Typical High $4,677.35 | Professional | None | $151.36 | $2,570.40 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,511.38 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $11,220.18 | Professional | None | $213.80 | $234.42 | $11,220.18 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $1,548.82 Typical High $3,801.89 | Facility | None | $95.50 | $1,548.82 | $3,801.89 |
Blue Shield Setting Professional Modifier None Typical Low $120.23 Median $1,621.81 Typical High $4,677.35 | Professional | None | $120.23 | $1,621.81 | $4,677.35 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $147.91 Median $3,090.30 Typical High $4,073.80 | Professional | None | $147.91 | $3,090.30 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $6,025.60 Typical High $10,232.93 | Facility | None | $758.58 | $6,025.60 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $2,398.83 Typical High $4,897.79 | Professional | None | $169.82 | $2,398.83 | $4,897.79 |
Contra Costa Health Setting Professional Modifier None Typical Low $162.18 Median $2,691.53 Typical High $3,981.07 | Professional | None | $162.18 | $2,691.53 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $2,344.23 Typical High $5,011.87 | Professional | None | $151.36 | $2,344.23 | $5,011.87 |
Lucent Health Setting Professional Modifier None Typical Low $17,378.01 Median $20,892.96 Typical High $20,892.96 | Professional | None | $17,378.01 | $20,892.96 | $20,892.96 |
Providence Setting Facility Modifier None Typical Low $676.08 Median $6,025.60 Typical High $12,882.50 | Facility | None | $676.08 | $6,025.60 | $12,882.50 |
Providence Setting Professional Modifier None Typical Low $169.82 Median $2,041.74 Typical High $4,897.79 | Professional | None | $169.82 | $2,041.74 | $4,897.79 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,754.40 | $17,378.01 |
United Setting Professional Modifier None Typical Low $147.91 Median $2,511.89 Typical High $5,888.44 | Professional | None | $147.91 | $2,511.89 | $5,888.44 |
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 $75.86 Median $81.28 Typical High $1,584.89 | Facility | 52 · Reduced service | $75.86 | $81.28 | $1,584.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.20 Median $32.36 Typical High $630.96 | Facility | 53 · Discontinued | $30.20 | $32.36 | $630.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.39 Median $24.55 Typical High $478.63 | Facility | 55 · Aftercare only | $22.39 | $24.55 | $478.63 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.22 Typical High $316.23 | Facility | 56 · Pre-op care only | $15.14 | $16.22 | $316.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $1,122.02 Typical High $1,548.82 | Professional | 52 · Reduced service | $75.86 | $1,122.02 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $446.68 Typical High $630.96 | Professional | 53 · Discontinued | $30.20 | $446.68 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $1,659.59 Typical High $2,290.87 | Professional | 54 · Surgery only | $112.20 | $1,659.59 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $331.13 Typical High $467.74 | Professional | 55 · Aftercare only | $22.39 | $331.13 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $223.87 Typical High $316.23 | Professional | 56 · Pre-op care only | $15.14 | $223.87 | $316.23 |
Where California sits
The same service costs 33.1 times more in Alaska than in Kentucky. 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· 22nd of 51
$2,570
AK $5,495KY $166
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.