How much rates vary
Facilitymedian $6,166 · 10th to 90th $316 to $15,136Professionalmedian $1,047 · 10th to 90th $195 to $4,365
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 $1,202.26 Median $5,888.44 Typical High $15,848.93 | Facility | None | $1,202.26 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $1,047.13 Typical High $1,621.81 | Professional | None | $186.21 | $1,047.13 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $8,317.64 Typical High $16,982.44 | Facility | None | $4,265.80 | $8,317.64 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $1,047.13 Typical High $3,019.95 | Professional | None | $275.42 | $1,047.13 | $3,019.95 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $3,235.94 Typical High $7,079.46 | Facility | None | $69.18 | $3,235.94 | $7,079.46 |
Blue Shield Setting Professional Modifier None Typical Low $158.49 Median $870.96 Typical High $1,548.82 | Professional | None | $158.49 | $870.96 | $1,548.82 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $1,445.44 | Professional | None | $173.78 | $263.03 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $870.96 Typical High $1,778.28 | Professional | None | $213.80 | $870.96 | $1,778.28 |
Contra Costa Health Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $1,412.54 | Professional | None | $173.78 | $208.93 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $812.83 Typical High $1,659.59 | Professional | None | $165.96 | $812.83 | $1,659.59 |
Lucent Health Setting Professional Modifier None Typical Low $6,760.83 Median $8,317.64 Typical High $8,317.64 | Professional | None | $6,760.83 | $8,317.64 | $8,317.64 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $794.33 Typical High $1,318.26 | Professional | None | $33.11 | $794.33 | $1,318.26 |
Providence Setting Facility Modifier None Typical Low $194.98 Median $537.03 Typical High $1,862.09 | Facility | None | $194.98 | $537.03 | $1,862.09 |
Providence Setting Professional Modifier None Typical Low $213.80 Median $933.25 Typical High $1,737.80 | Professional | None | $213.80 | $933.25 | $1,737.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $3,548.13 | Professional | None | $630.96 | $630.96 | $3,548.13 |
United Setting Facility Modifier None Typical Low $5,248.07 Median $9,772.37 Typical High $20,892.96 | Facility | None | $5,248.07 | $9,772.37 | $20,892.96 |
United Setting Professional Modifier None Typical Low $173.78 Median $870.96 Typical High $1,949.84 | Professional | None | $173.78 | $870.96 | $1,949.84 |
9 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 $97.72 Median $102.33 Typical High $676.08 | Facility | 52 · Reduced service | $97.72 | $102.33 | $676.08 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.90 Median $40.74 Typical High $269.15 | Facility | 53 · Discontinued | $38.90 | $40.74 | $269.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $30.20 Typical High $199.53 | Facility | 55 · Aftercare only | $28.84 | $30.20 | $199.53 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.50 Median $20.42 Typical High $134.90 | Facility | 56 · Pre-op care only | $19.50 | $20.42 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $398.11 Typical High $660.69 | Professional | 52 · Reduced service | $97.72 | $398.11 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $158.49 Typical High $269.15 | Professional | 53 · Discontinued | $38.90 | $158.49 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $588.84 Typical High $977.24 | Professional | 54 · Surgery only | $144.54 | $588.84 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $117.49 Typical High $199.53 | Professional | 55 · Aftercare only | $28.84 | $117.49 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $79.43 Typical High $134.90 | Professional | 56 · Pre-op care only | $19.50 | $79.43 | $134.90 |
Where California sits
The same service costs 5.9 times more in Wisconsin than in Maryland. 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· 17th of 51
$1,072
WI $1,622MD $275
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.