How much rates vary
Facilitymedian $2,884 · 10th to 90th $575 to $151,356Professionalmedian $3,890 · 10th to 90th $1,122 to $15,849
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 $1,122.02 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,122.02 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,818.38 | Professional | None | $1,122.02 | $1,122.02 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $15,848.93 Typical High $29,512.09 | Facility | None | $7,585.78 | $15,848.93 | $29,512.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,715.35 Median $4,073.80 Typical High $7,943.28 | Professional | None | $3,715.35 | $4,073.80 | $7,943.28 |
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 $812.83 Median $1,148.15 Typical High $2,089.30 | Professional | None | $812.83 | $1,148.15 | $2,089.30 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,584.89 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,348.96 Typical High $10,000.00 | Facility | None | $660.69 | $1,348.96 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $3,311.31 Typical High $8,709.64 | Professional | None | $1,995.26 | $3,311.31 | $8,709.64 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $3,801.89 | Professional | None | $1,548.82 | $1,778.28 | $3,801.89 |
Lucent Health Setting Professional Modifier None Typical Low $15,848.93 Median $15,848.93 Typical High $16,982.44 | Professional | None | $15,848.93 | $15,848.93 | $16,982.44 |
Molina Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $151,356.12 Typical High $251,188.64 | Facility | None | $794.33 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,995.26 Median $2,818.38 Typical High $8,709.64 | Professional | None | $1,995.26 | $2,818.38 | $8,709.64 |
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 $1,348.96 Median $2,137.96 Typical High $5,248.07 | Professional | None | $1,348.96 | $2,137.96 | $5,248.07 |
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 $562.34 Median $562.34 Typical High $1,230.27 | Professional | 52 · Reduced service | $562.34 | $562.34 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $489.78 | Professional | 53 · Discontinued | $223.87 | $223.87 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,862.09 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $371.54 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $245.47 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $245.47 |
Where California sits
The same service costs 5.6 times more in Alaska than in South Carolina. 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· 12th of 51
$3,890
AK $9,550SC $1,698
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.