How much rates vary
Facilitymedian $4,786 · 10th to 90th $955 to $11,749Professionalmedian $269 · 10th to 90th $195 to $1,445
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 $2,238.72 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,238.72 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $2,398.83 | Professional | None | $204.17 | $204.17 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $6,760.83 Typical High $13,489.63 | Facility | None | $2,951.21 | $6,760.83 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $812.83 | Professional | None | $257.04 | $281.84 | $812.83 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,905.46 Typical High $7,943.28 | Facility | None | $100.00 | $1,905.46 | $7,943.28 |
Blue Shield Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $575.44 | Professional | None | $169.82 | $239.88 | $575.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $331.13 | Professional | None | $177.83 | $218.78 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,495.41 Typical High $8,709.64 | Facility | None | $758.58 | $5,495.41 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $676.08 | Professional | None | $208.93 | $263.03 | $676.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $257.04 | Professional | None | $194.98 | $213.80 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $478.63 | Professional | None | $177.83 | $223.87 | $478.63 |
Lucent Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,445.44 | $1,479.11 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $5,623.41 Typical High $11,748.98 | Facility | None | $660.69 | $5,623.41 | $11,748.98 |
Providence Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $602.56 | Professional | None | $208.93 | $263.03 | $602.56 |
Sutter Health Plus Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,365.16 | $14,454.40 |
United Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $602.56 | Professional | None | $165.96 | $229.09 | $602.56 |
5 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 Professional Modifier 52 · Reduced service Typical Low $102.33 Median $102.33 Typical High $114.82 | Professional | 52 · Reduced service | $102.33 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $45.71 | Professional | 53 · Discontinued | $40.74 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $154.88 Typical High $169.82 | Professional | 54 · Surgery only | $151.36 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $33.88 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $22.91 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $22.91 |
Where California sits
The same service costs 6.9 times more in Tennessee than in New York. 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· 20th of 51
$380
TN $1,413NY $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.