How much rates vary
Facilitymedian $676 · 10th to 90th $79 to $6,457Professionalmedian $91 · 10th to 90th $50 to $447
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 $95.50 Median $4,677.35 Typical High $15,135.61 | Facility | None | $95.50 | $4,677.35 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $89.13 Typical High $199.53 | Professional | None | $50.12 | $89.13 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $66.07 Median $72.44 Typical High $537.03 | Professional | None | $66.07 | $72.44 | $537.03 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $416.87 Typical High $1,698.24 | Facility | None | $95.50 | $416.87 | $1,698.24 |
Blue Shield Setting Professional Modifier None Typical Low $46.77 Median $87.10 Typical High $208.93 | Professional | None | $46.77 | $87.10 | $208.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $239.88 | Professional | None | $48.98 | $75.86 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $676.08 | Facility | None | $50.12 | $61.66 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $263.03 | Professional | None | $54.95 | $95.50 | $263.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $52.48 Median $66.07 Typical High $239.88 | Professional | None | $52.48 | $66.07 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $50.12 Median $158.49 Typical High $331.13 | Professional | None | $50.12 | $158.49 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,445.44 | Professional | None | $1,122.02 | $1,122.02 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $218.78 | Professional | None | $128.82 | $128.82 | $218.78 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $77.62 Typical High $676.08 | Facility | None | $50.12 | $77.62 | $676.08 |
Providence Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $263.03 | Professional | None | $54.95 | $95.50 | $263.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $478.63 | Professional | None | $181.97 | $181.97 | $478.63 |
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 $47.86 Median $109.65 Typical High $302.00 | Professional | None | $47.86 | $109.65 | $302.00 |
11 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 $25.12 Median $26.92 Typical High $47.86 | Facility | 52 · Reduced service | $25.12 | $26.92 | $47.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.00 Median $10.72 Typical High $19.50 | Facility | 53 · Discontinued | $10.00 | $10.72 | $19.50 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $38.02 Median $40.74 Typical High $72.44 | Facility | 54 · Surgery only | $38.02 | $40.74 | $72.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.59 Median $8.13 Typical High $14.45 | Facility | 55 · Aftercare only | $7.59 | $8.13 | $14.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.37 Typical High $9.55 | Facility | 56 · Pre-op care only | $5.01 | $5.37 | $9.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $38.90 Typical High $47.86 | Professional | 52 · Reduced service | $25.12 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $15.49 Typical High $19.50 | Professional | 53 · Discontinued | $10.00 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $57.54 Typical High $72.44 | Professional | 54 · Surgery only | $38.02 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $11.75 Typical High $14.45 | Professional | 55 · Aftercare only | $7.59 | $11.75 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $7.76 Typical High $9.55 | Professional | 56 · Pre-op care only | $5.01 | $7.76 | $9.55 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $81.28 Median $218.78 Typical High $524.81 | Professional | 50 · Both sides | $81.28 | $218.78 | $524.81 |
Where California sits
The same service costs 4.0 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· 48th of 51
$97.72
AK $316KY $79.43
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.