How much rates vary
Facilitymedian $1,175 · 10th to 90th $155 to $6,457Professionalmedian $209 · 10th to 90th $129 to $490
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 $478.63 Median $5,888.44 Typical High $15,848.93 | Facility | None | $478.63 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $323.59 | Professional | None | $120.23 | $204.17 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $263.03 | Professional | None | $173.78 | $194.98 | $263.03 |
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 $165.96 Median $251.19 Typical High $562.34 | Professional | None | $165.96 | $251.19 | $562.34 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,737.80 Typical High $4,897.79 | Facility | None | $100.00 | $1,737.80 | $4,897.79 |
Blue Shield Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $446.68 | Professional | None | $112.20 | $194.98 | $446.68 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $131.83 Median $229.09 Typical High $295.12 | Professional | None | $131.83 | $229.09 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $269.15 Typical High $954.99 | Facility | None | $169.82 | $269.15 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $371.54 | Professional | None | $134.90 | $208.93 | $371.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $275.42 | Professional | None | $120.23 | $181.97 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $218.78 Typical High $407.38 | Professional | None | $109.65 | $218.78 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $275.42 | Professional | None | $165.96 | $165.96 | $275.42 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $316.23 Typical High $2,570.40 | Facility | None | $165.96 | $316.23 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $371.54 | Professional | None | $134.90 | $204.17 | $371.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $630.96 | Professional | None | $389.05 | $389.05 | $630.96 |
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 $104.71 Median $190.55 Typical High $446.68 | Professional | None | $104.71 | $190.55 | $446.68 |
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 $64.57 Median $69.18 Typical High $112.20 | Facility | 52 · Reduced service | $64.57 | $69.18 | $112.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $27.54 Typical High $44.67 | Facility | 53 · Discontinued | $26.30 | $27.54 | $44.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $97.72 Median $102.33 Typical High $165.96 | Facility | 54 · Surgery only | $97.72 | $102.33 | $165.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $20.89 Typical High $33.11 | Facility | 55 · Aftercare only | $19.50 | $20.89 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.80 Typical High $22.39 | Facility | 56 · Pre-op care only | $12.88 | $13.80 | $22.39 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $89.13 Typical High $112.20 | Professional | 52 · Reduced service | $64.57 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $35.48 Typical High $44.67 | Professional | 53 · Discontinued | $26.30 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $131.83 Typical High $165.96 | Professional | 54 · Surgery only | $97.72 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $26.30 Typical High $33.11 | Professional | 55 · Aftercare only | $19.50 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $17.78 Typical High $22.39 | Professional | 56 · Pre-op care only | $12.88 | $17.78 | $22.39 |
Where California sits
The same service costs 3.0 times more in Wisconsin 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· 31st of 51
$219
WI $537MD $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.