How much rates vary
Facilitymedian $5,129 · 10th to 90th $589 to $13,804Professionalmedian $603 · 10th to 90th $141 to $2,188
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 $776.25 Median $5,754.40 Typical High $15,848.93 | Facility | None | $776.25 | $5,754.40 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $588.84 Typical High $794.33 | Professional | None | $134.90 | $588.84 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,511.38 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $616.60 Typical High $1,348.96 | Professional | None | $204.17 | $616.60 | $1,348.96 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $114.82 Median $436.52 Typical High $812.83 | Professional | None | $114.82 | $436.52 | $812.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $851.14 | Professional | None | $138.04 | $251.19 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $446.68 Typical High $977.24 | Professional | None | $151.36 | $446.68 | $977.24 |
Contra Costa Health Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $831.76 | Professional | None | $125.89 | $169.82 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $457.09 Typical High $977.24 | Professional | None | $112.20 | $457.09 | $977.24 |
Lucent Health Setting Professional Modifier None Typical Low $4,168.69 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,168.69 | $4,897.79 | $4,897.79 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $478.63 Typical High $794.33 | Professional | None | $33.11 | $478.63 | $794.33 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $302.00 Typical High $1,122.02 | Facility | None | $158.49 | $302.00 | $1,122.02 |
Providence Setting Professional Modifier None Typical Low $151.36 Median $457.09 Typical High $977.24 | Professional | None | $151.36 | $457.09 | $977.24 |
Sutter Health Plus Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $1,995.26 | Professional | None | $436.52 | $436.52 | $1,995.26 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $7,244.36 | Facility | None | $602.56 | $1,621.81 | $7,244.36 |
United Setting Professional Modifier None Typical Low $123.03 Median $489.78 Typical High $1,047.13 | Professional | None | $123.03 | $489.78 | $1,047.13 |
11 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 Facility Modifier 52 · Reduced service Typical Low $74.13 Median $77.62 Typical High $389.05 | Facility | 52 · Reduced service | $74.13 | $77.62 | $389.05 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.20 Median $30.90 Typical High $154.88 | Facility | 53 · Discontinued | $30.20 | $30.90 | $154.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $112.20 Median $114.82 Typical High $588.84 | Facility | 54 · Surgery only | $112.20 | $114.82 | $588.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.39 Median $23.44 Typical High $117.49 | Facility | 55 · Aftercare only | $22.39 | $23.44 | $117.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.49 Typical High $77.62 | Facility | 56 · Pre-op care only | $15.14 | $15.49 | $77.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $223.87 Typical High $389.05 | Professional | 52 · Reduced service | $72.44 | $223.87 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $89.13 Typical High $154.88 | Professional | 53 · Discontinued | $28.84 | $89.13 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $338.84 Typical High $588.84 | Professional | 54 · Surgery only | $107.15 | $338.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $67.61 Typical High $117.49 | Professional | 55 · Aftercare only | $21.38 | $67.61 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $44.67 Typical High $77.62 | Professional | 56 · Pre-op care only | $14.45 | $44.67 | $77.62 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $223.87 Median $794.33 Typical High $1,202.26 | Professional | 50 · Both sides | $223.87 | $794.33 | $1,202.26 |
Where California sits
The same service costs 3.8 times more in Wisconsin than in Nebraska. 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· 16th of 51
$603
WI $912NE $240
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.