How much rates vary
Facilitymedian $4,677 · 10th to 90th $603 to $18,197Professionalmedian $1,000 · 10th to 90th $646 to $5,129
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 $933.25 Median $8,511.38 Typical High $19,054.61 | Facility | None | $933.25 | $8,511.38 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $977.24 | Professional | None | $645.65 | $676.08 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,715.19 Typical High $19,498.45 | Facility | None | $5,248.07 | $10,715.19 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $2,754.23 | Professional | None | $977.24 | $1,071.52 | $2,754.23 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $12,589.25 Typical High $26,302.68 | Facility | None | $67.61 | $12,589.25 | $26,302.68 |
Blue Shield Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,513.56 | Professional | None | $537.03 | $758.58 | $1,513.56 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,023.29 | Professional | None | $602.56 | $776.25 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,122.02 Typical High $5,623.41 | Facility | None | $660.69 | $1,122.02 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $2,238.72 | Professional | None | $724.44 | $891.25 | $2,238.72 |
Contra Costa Health Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $912.01 | Professional | None | $602.56 | $758.58 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,862.09 | Professional | None | $630.96 | $794.33 | $1,862.09 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,888.44 | Professional | None | $5,128.61 | $5,128.61 | $5,888.44 |
Molina Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $1,000.00 Typical High $5,623.41 | Facility | None | $660.69 | $1,000.00 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $2,238.72 | Professional | None | $691.83 | $870.96 | $2,238.72 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
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 $616.60 Median $870.96 Typical High $2,187.76 | Professional | None | $616.60 | $870.96 | $2,187.76 |
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 $323.59 Median $331.13 Typical High $416.87 | Professional | 52 · Reduced service | $323.59 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $134.90 Typical High $165.96 | Professional | 53 · Discontinued | $131.83 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $501.19 Typical High $630.96 | Professional | 54 · Surgery only | $489.78 | $501.19 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $125.89 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $83.18 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $83.18 |
Where California sits
The same service costs 3.8 times more in Wisconsin 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
$1,096
WI $2,951NY $776
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.