How much rates vary
Facilitymedian $1,905 · 10th to 90th $501 to $7,244Professionalmedian $234 · 10th to 90th $117 to $1,047
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 $114.82 Median $213.80 Typical High $323.59 | Professional | None | $114.82 | $213.80 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $2,137.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $263.03 Typical High $691.83 | Professional | None | $147.91 | $263.03 | $691.83 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,905.46 Typical High $6,309.57 | Facility | None | $100.00 | $1,905.46 | $6,309.57 |
Blue Shield Setting Professional Modifier None Typical Low $97.72 Median $186.21 Typical High $446.68 | Professional | None | $97.72 | $186.21 | $446.68 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $389.05 | Professional | None | $107.15 | $131.83 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,318.26 Typical High $2,630.27 | Facility | None | $575.44 | $1,318.26 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $213.80 Typical High $478.63 | Professional | None | $120.23 | $213.80 | $478.63 |
Contra Costa Health Setting Professional Modifier None Typical Low $117.49 Median $346.74 Typical High $416.87 | Professional | None | $117.49 | $346.74 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $288.40 Typical High $549.54 | Professional | None | $107.15 | $288.40 | $549.54 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,905.46 | $1,905.46 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $371.54 | Professional | None | $223.87 | $223.87 | $371.54 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $1,288.25 Typical High $4,265.80 | Facility | None | $302.00 | $1,288.25 | $4,265.80 |
Providence Setting Professional Modifier None Typical Low $120.23 Median $213.80 Typical High $467.74 | Professional | None | $120.23 | $213.80 | $467.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $891.25 | Professional | None | $380.19 | $380.19 | $891.25 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $97.72 Median $213.80 Typical High $575.44 | Professional | None | $97.72 | $213.80 | $575.44 |
10 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 $57.54 Median $60.26 Typical High $117.49 | Facility | 52 · Reduced service | $57.54 | $60.26 | $117.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.91 Median $23.99 Typical High $47.86 | Facility | 53 · Discontinued | $22.91 | $23.99 | $47.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $85.11 Median $91.20 Typical High $177.83 | Facility | 54 · Surgery only | $85.11 | $91.20 | $177.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.98 Median $18.20 Typical High $35.48 | Facility | 55 · Aftercare only | $16.98 | $18.20 | $35.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.02 Typical High $23.44 | Facility | 56 · Pre-op care only | $11.48 | $12.02 | $23.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $93.33 Typical High $117.49 | Professional | 52 · Reduced service | $57.54 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $37.15 Typical High $47.86 | Professional | 53 · Discontinued | $22.91 | $37.15 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $138.04 Typical High $177.83 | Professional | 54 · Surgery only | $85.11 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $27.54 Typical High $35.48 | Professional | 55 · Aftercare only | $16.98 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $18.62 Typical High $23.44 | Professional | 56 · Pre-op care only | $11.48 | $18.62 | $23.44 |
Where California sits
The same service costs 3.9 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· 36th of 51
$263
AK $708KY $182
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.