How much rates vary
Facilitymedian $2,692 · 10th to 90th $537 to $18,197Professionalmedian $112 · 10th to 90th $78 to $389
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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $83.18 Typical High $1,584.89 | Professional | None | $81.28 | $83.18 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,365.16 Typical High $9,549.93 | Facility | None | $2,511.89 | $4,365.16 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $323.59 | Professional | None | $102.33 | $120.23 | $323.59 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $977.24 Typical High $4,786.30 | Facility | None | $95.50 | $977.24 | $4,786.30 |
Blue Shield Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $251.19 | Professional | None | $77.62 | $112.20 | $251.19 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $56.23 Median $79.43 Typical High $85.11 | Professional | None | $56.23 | $79.43 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $10,000.00 | Facility | None | $660.69 | $1,258.93 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $245.47 | Professional | None | $83.18 | $97.72 | $245.47 |
Contra Costa Health Setting Professional Modifier None Typical Low $44.67 Median $77.62 Typical High $93.33 | Professional | None | $44.67 | $77.62 | $93.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $186.21 | Professional | None | $69.18 | $87.10 | $186.21 |
Lucent Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
Molina Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $151,356.12 Typical High $251,188.64 | Facility | None | $165.96 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $245.47 | Professional | None | $83.18 | $97.72 | $245.47 |
Sutter Health Plus Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $229.09 | Professional | None | $63.10 | $87.10 | $229.09 |
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 $39.81 Median $41.69 Typical High $45.71 | Professional | 52 · Reduced service | $39.81 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.60 Typical High $18.20 | Professional | 53 · Discontinued | $15.85 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $63.10 Typical High $67.61 | Professional | 54 · Surgery only | $60.26 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.59 Typical High $13.49 | Professional | 55 · Aftercare only | $12.02 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.32 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.94 | $8.32 | $9.12 |
Where California sits
The same service costs 6.5 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· 24th of 51
$138
TN $513NY $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.