How much rates vary
Facilitymedian $2,692 · 10th to 90th $457 to $151,356Professionalmedian $363 · 10th to 90th $224 to $1,622
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 $223.87 Median $245.47 Typical High $489.78 | Professional | None | $223.87 | $245.47 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $13,803.84 Typical High $25,118.86 | Facility | None | $5,370.32 | $13,803.84 | $25,118.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $954.99 | Professional | None | $316.23 | $407.38 | $954.99 |
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 $223.87 Median $323.59 Typical High $602.56 | Professional | None | $223.87 | $323.59 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $10,000.00 | Facility | None | $660.69 | $1,258.93 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $741.31 | Professional | None | $234.42 | $288.40 | $741.31 |
Contra Costa Health Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $269.15 | Professional | None | $173.78 | $245.47 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $616.60 | Professional | None | $199.53 | $257.04 | $616.60 |
Lucent Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,621.81 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $151,356.12 Typical High $251,188.64 | Facility | None | $616.60 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $707.95 | Professional | None | $234.42 | $275.42 | $707.95 |
Sutter Health Plus Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
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 $194.98 Median $275.42 Typical High $691.83 | Professional | None | $194.98 | $275.42 | $691.83 |
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 $114.82 Median $123.03 Typical High $128.82 | Professional | 52 · Reduced service | $114.82 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $48.98 Typical High $51.29 | Professional | 53 · Discontinued | $45.71 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $181.97 Typical High $194.98 | Professional | 54 · Surgery only | $162.18 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $36.31 Typical High $38.90 | Professional | 55 · Aftercare only | $33.88 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $24.55 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.91 | $24.55 | $25.70 |
Where California sits
The same service costs 4.0 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· 19th of 51
$427
WI $1,000NY $251
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.