How much rates vary
Facilitymedian $1,230 · 10th to 90th $166 to $6,918Professionalmedian $263 · 10th to 90th $126 to $1,072
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 $645.65 Median $5,888.44 Typical High $15,848.93 | Facility | None | $645.65 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $309.03 | Professional | None | $123.03 | $229.09 | $309.03 |
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 $144.54 Median $275.42 Typical High $691.83 | Professional | None | $144.54 | $275.42 | $691.83 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,778.28 Typical High $6,165.95 | Facility | None | $100.00 | $1,778.28 | $6,165.95 |
Blue Shield Setting Professional Modifier None Typical Low $107.15 Median $213.80 Typical High $489.78 | Professional | None | $107.15 | $213.80 | $489.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $398.11 | Professional | None | $107.15 | $147.91 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $446.68 Typical High $1,023.29 | Facility | None | $288.40 | $446.68 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $489.78 | Professional | None | $138.04 | $251.19 | $489.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $83.18 Median $147.91 Typical High $389.05 | Professional | None | $83.18 | $147.91 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $288.40 Typical High $549.54 | Professional | None | $123.03 | $288.40 | $549.54 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,949.84 | $1,949.84 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $380.19 | Professional | None | $229.09 | $229.09 | $380.19 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $457.09 Typical High $3,311.31 | Facility | None | $251.19 | $457.09 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $489.78 | Professional | None | $138.04 | $251.19 | $489.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $870.96 | Professional | None | $436.52 | $436.52 | $870.96 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,090.30 | Facility | None | $123.03 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $109.65 Median $229.09 Typical High $575.44 | Professional | None | $109.65 | $229.09 | $575.44 |
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 $63.10 Median $67.61 Typical High $141.25 | Facility | 52 · Reduced service | $63.10 | $67.61 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $26.92 Typical High $56.23 | Facility | 53 · Discontinued | $25.12 | $26.92 | $56.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $95.50 Median $100.00 Typical High $208.93 | Facility | 54 · Surgery only | $95.50 | $100.00 | $208.93 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.05 Median $19.95 Typical High $41.69 | Facility | 55 · Aftercare only | $19.05 | $19.95 | $41.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.49 Typical High $28.18 | Facility | 56 · Pre-op care only | $12.59 | $13.49 | $28.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $109.65 Typical High $141.25 | Professional | 52 · Reduced service | $63.10 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $43.65 Typical High $56.23 | Professional | 53 · Discontinued | $25.12 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $162.18 Typical High $208.93 | Professional | 54 · Surgery only | $95.50 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $32.36 Typical High $41.69 | Professional | 55 · Aftercare only | $19.05 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $21.88 Typical High $28.18 | Professional | 56 · Pre-op care only | $12.59 | $21.88 | $28.18 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | 50 · Both sides | $416.87 | $436.52 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $380.19 Typical High $758.58 | Professional | 50 · Both sides | $208.93 | $380.19 | $758.58 |
Where California sits
The same service costs 3.2 times more in Wisconsin 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· 30th of 51
$275
WI $646KY $204
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.