How much rates vary
Facilitymedian $2,692 · 10th to 90th $372 to $15,136Professionalmedian $372 · 10th to 90th $257 to $3,090
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 $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $389.05 | Professional | None | $269.15 | $275.42 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $11,748.98 Typical High $20,417.38 | Facility | None | $5,888.44 | $11,748.98 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $1,096.48 | Professional | None | $371.54 | $436.52 | $1,096.48 |
Blue Shield Setting Facility Modifier None Typical Low $48.98 Median $79.43 Typical High $100.00 | Facility | None | $48.98 | $79.43 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $676.08 | Professional | None | $245.47 | $346.74 | $676.08 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $489.78 | Professional | None | $251.19 | $295.12 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,174.90 Typical High $5,623.41 | Facility | None | $660.69 | $1,174.90 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $776.25 | Professional | None | $275.42 | $316.23 | $776.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $346.74 | Professional | None | $257.04 | $288.40 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $741.31 | Professional | None | $239.88 | $302.00 | $741.31 |
Lucent Health Setting Professional Modifier None Typical Low $3,090.30 Median $14,791.08 Typical High $14,791.08 | Professional | None | $3,090.30 | $14,791.08 | $14,791.08 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $870.96 Typical High $5,623.41 | Facility | None | $309.03 | $870.96 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $776.25 | Professional | None | $263.03 | $309.03 | $776.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
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 $234.42 Median $316.23 Typical High $851.14 | Professional | None | $234.42 | $316.23 | $851.14 |
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 $125.89 Median $134.90 Typical High $158.49 | Professional | 52 · Reduced service | $125.89 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $53.70 Typical High $64.57 | Professional | 53 · Discontinued | $51.29 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $204.17 Typical High $239.88 | Professional | 54 · Surgery only | $190.55 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $40.74 Typical High $47.86 | Professional | 55 · Aftercare only | $38.02 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.92 Typical High $32.36 | Professional | 56 · Pre-op care only | $25.70 | $26.92 | $32.36 |
Where California sits
The same service costs 3.9 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· 28th of 51
$447
WI $1,175NY $302
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.