How much rates vary
Facilitymedian $4,074 · 10th to 90th $525 to $23,442Professionalmedian $537 · 10th to 90th $363 to $2,951
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 $3,715.35 Median $10,000.00 Typical High $20,892.96 | Facility | None | $3,715.35 | $10,000.00 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $6,760.83 | Professional | None | $380.19 | $398.11 | $6,760.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,709.64 Median $17,782.79 Typical High $40,738.03 | Facility | None | $8,709.64 | $17,782.79 | $40,738.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $1,621.81 | Professional | None | $512.86 | $562.34 | $1,621.81 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $954.99 Typical High $2,041.74 | Facility | None | $67.61 | $954.99 | $2,041.74 |
Blue Shield Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $831.76 | Professional | None | $288.40 | $416.87 | $831.76 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $602.56 | Professional | None | $346.74 | $426.58 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,122.02 Typical High $5,623.41 | Facility | None | $645.65 | $1,122.02 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $1,174.90 | Professional | None | $407.38 | $489.78 | $1,174.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $489.78 | Professional | None | $354.81 | $416.87 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $1,047.13 | Professional | None | $338.84 | $436.52 | $1,047.13 |
Lucent Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,951.21 | $3,235.94 | $3,235.94 |
Providence Setting Facility Modifier None Typical Low $446.68 Median $891.25 Typical High $5,623.41 | Facility | None | $446.68 | $891.25 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $1,174.90 | Professional | None | $398.11 | $489.78 | $1,174.90 |
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 $346.74 Median $489.78 Typical High $1,288.25 | Professional | None | $346.74 | $489.78 | $1,288.25 |
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 $190.55 Median $199.53 Typical High $239.88 | Professional | 52 · Reduced service | $190.55 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $95.50 | Professional | 53 · Discontinued | $75.86 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $295.12 Typical High $363.08 | Professional | 54 · Surgery only | $281.84 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $58.88 Typical High $70.79 | Professional | 55 · Aftercare only | $56.23 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $47.86 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $47.86 |
Where California sits
The same service costs 4.5 times more in Wisconsin than in Kentucky. 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· 15th of 51
$708
WI $1,778KY $398
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.