How much rates vary
Facilitymedian $12,589 · 10th to 90th $708 to $37,154Professionalmedian $417 · 10th to 90th $288 to $2,291
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 $3,890.45 Median $10,000.00 Typical High $20,892.96 | Facility | None | $3,890.45 | $10,000.00 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $10,964.78 | Professional | None | $295.12 | $309.03 | $10,964.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,762.47 Median $16,982.44 Typical High $29,512.09 | Facility | None | $7,762.47 | $16,982.44 | $29,512.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $1,288.25 | Professional | None | $398.11 | $436.52 | $1,288.25 |
Blue Shield Setting Facility Modifier None Typical Low $74.13 Median $6,760.83 Typical High $15,488.17 | Facility | None | $74.13 | $6,760.83 | $15,488.17 |
Blue Shield Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $691.83 | Professional | None | $245.47 | $354.81 | $691.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $467.74 | Professional | None | $275.42 | $331.13 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $5,623.41 | Facility | None | $660.69 | $1,258.93 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $954.99 | Professional | None | $309.03 | $380.19 | $954.99 |
Contra Costa Health Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $407.38 | Professional | None | $275.42 | $331.13 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $831.76 | Professional | None | $269.15 | $338.84 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,290.87 | $2,454.71 | $2,454.71 |
Providence Setting Facility Modifier None Typical Low $346.74 Median $954.99 Typical High $5,623.41 | Facility | None | $346.74 | $954.99 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $954.99 | Professional | None | $302.00 | $380.19 | $954.99 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
United Setting Facility Modifier None Typical Low $12,022.64 Median $23,988.33 Typical High $56,234.13 | Facility | None | $12,022.64 | $23,988.33 | $56,234.13 |
United Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $1,000.00 | Professional | None | $269.15 | $380.19 | $1,000.00 |
6 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 $147.91 Median $154.88 Typical High $186.21 | Professional | 52 · Reduced service | $147.91 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $61.66 Typical High $74.13 | Professional | 53 · Discontinued | $58.88 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $234.42 Typical High $281.84 | Professional | 54 · Surgery only | $223.87 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $46.77 Typical High $56.23 | Professional | 55 · Aftercare only | $44.67 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $30.90 Typical High $36.31 | Professional | 56 · Pre-op care only | $29.51 | $30.90 | $36.31 |
Ambetter Setting Professional Modifier Q0 · Research study, investigational Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | Q0 · Research study, investigational | $257.04 | $257.04 | $257.04 |
Where California sits
The same service costs 45.0 times more in New Mexico than in Montana. 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.
Physician feeFacility fee
NM $44,130MT $980
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.