How much rates vary
Facilitymedian $1,549 · 10th to 90th $347 to $7,079Professionalmedian $148 · 10th to 90th $91 to $575
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 $128.82 Median $7,079.46 Typical High $18,197.01 | Facility | None | $128.82 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $112.20 Typical High $134.90 | Professional | None | $91.20 | $112.20 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $363.08 | Professional | None | $120.23 | $169.82 | $363.08 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,238.72 Typical High $5,754.40 | Facility | None | $100.00 | $2,238.72 | $5,754.40 |
Blue Shield Setting Professional Modifier None Typical Low $77.62 Median $138.04 Typical High $309.03 | Professional | None | $77.62 | $138.04 | $309.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $186.21 | Professional | None | $74.13 | $102.33 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $588.84 Typical High $1,174.90 | Facility | None | $389.05 | $588.84 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $245.47 | Professional | None | $91.20 | $128.82 | $245.47 |
Contra Costa Health Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $181.97 | Professional | None | $66.07 | $102.33 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $295.12 | Professional | None | $85.11 | $147.91 | $295.12 |
Lucent Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,148.15 | Professional | None | $933.25 | $933.25 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $177.83 | Professional | None | $107.15 | $107.15 | $177.83 |
Providence Setting Facility Modifier None Typical Low $169.82 Median $602.56 Typical High $2,570.40 | Facility | None | $169.82 | $602.56 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $245.47 | Professional | None | $91.20 | $125.89 | $245.47 |
Sutter Health Plus Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $416.87 | Professional | None | $295.12 | $295.12 | $416.87 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $4,677.35 | Facility | None | $398.11 | $1,202.26 | $4,677.35 |
United Setting Professional Modifier None Typical Low $77.62 Median $123.03 Typical High $309.03 | Professional | None | $77.62 | $123.03 | $309.03 |
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 $45.71 Median $48.98 Typical High $67.61 | Facility | 52 · Reduced service | $45.71 | $48.98 | $67.61 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.62 Median $19.50 Typical High $26.92 | Facility | 53 · Discontinued | $18.62 | $19.50 | $26.92 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $69.18 Median $72.44 Typical High $102.33 | Facility | 54 · Surgery only | $69.18 | $72.44 | $102.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.80 Median $14.79 Typical High $20.42 | Facility | 55 · Aftercare only | $13.80 | $14.79 | $20.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.77 Typical High $13.49 | Facility | 56 · Pre-op care only | $9.12 | $9.77 | $13.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $56.23 Typical High $67.61 | Professional | 52 · Reduced service | $45.71 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $22.39 Typical High $26.92 | Professional | 53 · Discontinued | $18.62 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $83.18 Typical High $102.33 | Professional | 54 · Surgery only | $69.18 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.60 Typical High $20.42 | Professional | 55 · Aftercare only | $13.80 | $16.60 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.22 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.12 | $11.22 | $13.49 |
Where California sits
The same service costs 3.5 times more in Alaska than in Indiana. 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· 22nd of 51
$170
AK $447IN $126
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.