How much rates vary
Facilitymedian $2,692 · 10th to 90th $457 to $151,356Professionalmedian $339 · 10th to 90th $219 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 $213.80 Median $229.09 Typical High $309.03 | Professional | None | $213.80 | $229.09 | $309.03 |
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 $380.19 Typical High $912.01 | Professional | None | $316.23 | $380.19 | $912.01 |
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 $213.80 Median $309.03 Typical High $575.44 | Professional | None | $213.80 | $309.03 | $575.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $275.42 | Professional | None | $181.97 | $251.19 | $275.42 |
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 $223.87 Median $275.42 Typical High $676.08 | Professional | None | $223.87 | $275.42 | $676.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $269.15 | Professional | None | $162.18 | $239.88 | $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 $218.78 Median $269.15 Typical High $676.08 | Professional | None | $218.78 | $269.15 | $676.08 |
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 $190.55 Median $269.15 Typical High $691.83 | Professional | None | $190.55 | $269.15 | $691.83 |
4 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 $107.15 Median $112.20 Typical High $125.89 | Professional | 52 · Reduced service | $107.15 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $45.71 Typical High $51.29 | Professional | 53 · Discontinued | $42.66 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $33.88 Typical High $38.02 | Professional | 55 · Aftercare only | $32.36 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.91 Typical High $25.12 | Professional | 56 · Pre-op care only | $21.38 | $22.91 | $25.12 |
Where California sits
The same service costs 4.1 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· 18th of 51
$437
WI $1,000NY $245
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.