How much rates vary
Facilitymedian $6,166 · 10th to 90th $457 to $15,136Professionalmedian $1,445 · 10th to 90th $295 to $5,248
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 $1,548.82 Median $5,888.44 Typical High $15,848.93 | Facility | None | $1,548.82 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $1,412.54 Typical High $2,511.89 | Professional | None | $281.84 | $1,412.54 | $2,511.89 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $398.11 Median $1,412.54 Typical High $4,265.80 | Professional | None | $398.11 | $1,412.54 | $4,265.80 |
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 $229.09 Median $1,174.90 Typical High $2,137.96 | Professional | None | $229.09 | $1,174.90 | $2,137.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $2,691.53 | Professional | None | $281.84 | $380.19 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $1,348.96 Typical High $2,570.40 | Professional | None | $316.23 | $1,348.96 | $2,570.40 |
Contra Costa Health Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $2,630.27 | Professional | None | $257.04 | $331.13 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $1,230.27 Typical High $3,090.30 | Professional | None | $275.42 | $1,230.27 | $3,090.30 |
Lucent Health Setting Professional Modifier None Typical Low $11,220.18 Median $15,488.17 Typical High $15,488.17 | Professional | None | $11,220.18 | $15,488.17 | $15,488.17 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,288.25 Typical High $2,137.96 | Professional | None | $33.11 | $1,288.25 | $2,137.96 |
Providence Setting Facility Modifier None Typical Low $295.12 Median $776.25 Typical High $2,570.40 | Facility | None | $295.12 | $776.25 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $316.23 Median $1,412.54 Typical High $2,630.27 | Professional | None | $316.23 | $1,412.54 | $2,630.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $5,128.61 | Professional | None | $1,000.00 | $1,000.00 | $5,128.61 |
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 $275.42 Median $1,258.93 Typical High $2,818.38 | Professional | None | $275.42 | $1,258.93 | $2,818.38 |
10 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 $141.25 Median $151.36 Typical High $891.25 | Facility | 52 · Reduced service | $141.25 | $151.36 | $891.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $363.08 | Facility | 53 · Discontinued | $56.23 | $60.26 | $363.08 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $269.15 | Facility | 55 · Aftercare only | $42.66 | $44.67 | $269.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $177.83 | Facility | 56 · Pre-op care only | $28.18 | $30.20 | $177.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $524.81 Typical High $891.25 | Professional | 52 · Reduced service | $141.25 | $524.81 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $213.80 Typical High $363.08 | Professional | 53 · Discontinued | $56.23 | $213.80 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $794.33 Typical High $1,348.96 | Professional | 54 · Surgery only | $213.80 | $794.33 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $158.49 Typical High $269.15 | Professional | 55 · Aftercare only | $42.66 | $158.49 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $104.71 Typical High $177.83 | Professional | 56 · Pre-op care only | $28.18 | $104.71 | $177.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $2,187.76 Typical High $3,715.35 | Professional | 50 · Both sides | $489.78 | $2,187.76 | $3,715.35 |
Where California sits
The same service costs 5.6 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· 29th of 51
$1,479
WI $2,570MD $457
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.