How much rates vary
Facilitymedian $4,169 · 10th to 90th $302 to $12,303Professionalmedian $1,148 · 10th to 90th $219 to $4,467
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 $5,128.61 Typical High $15,135.61 | Facility | None | $1,202.26 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $1,096.48 Typical High $1,905.46 | Professional | None | $199.53 | $1,096.48 | $1,905.46 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
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 $288.40 Median $1,096.48 Typical High $3,311.31 | Professional | None | $288.40 | $1,096.48 | $3,311.31 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,456.54 | Facility | None | $67.61 | $3,090.30 | $6,456.54 |
Blue Shield Setting Professional Modifier None Typical Low $165.96 Median $891.25 Typical High $1,621.81 | Professional | None | $165.96 | $891.25 | $1,621.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $2,344.23 | Professional | None | $213.80 | $269.15 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $1,122.02 Typical High $2,187.76 | Professional | None | $234.42 | $1,122.02 | $2,187.76 |
Contra Costa Health Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $2,290.87 | Professional | None | $181.97 | $251.19 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $1,348.96 Typical High $2,691.53 | Professional | None | $208.93 | $1,348.96 | $2,691.53 |
Lucent Health Setting Professional Modifier None Typical Low $9,120.11 Median $13,489.63 Typical High $13,489.63 | Professional | None | $9,120.11 | $13,489.63 | $13,489.63 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,047.13 Typical High $1,737.80 | Professional | None | $33.11 | $1,047.13 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $213.80 Median $549.54 Typical High $2,187.76 | Facility | None | $213.80 | $549.54 | $2,187.76 |
Providence Setting Professional Modifier None Typical Low $234.42 Median $1,202.26 Typical High $2,238.72 | Professional | None | $234.42 | $1,202.26 | $2,238.72 |
Sutter Health Plus Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $4,466.84 | Professional | None | $758.58 | $758.58 | $4,466.84 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $7,244.36 | Facility | None | $602.56 | $1,698.24 | $7,244.36 |
United Setting Professional Modifier None Typical Low $208.93 Median $1,047.13 Typical High $2,454.71 | Professional | None | $208.93 | $1,047.13 | $2,454.71 |
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 $100.00 Median $107.15 Typical High $691.83 | Facility | 52 · Reduced service | $100.00 | $107.15 | $691.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $39.81 Median $42.66 Typical High $275.42 | Facility | 53 · Discontinued | $39.81 | $42.66 | $275.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $32.36 Typical High $208.93 | Facility | 55 · Aftercare only | $30.20 | $32.36 | $208.93 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.38 Typical High $138.04 | Facility | 56 · Pre-op care only | $19.95 | $21.38 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $457.09 Typical High $691.83 | Professional | 52 · Reduced service | $100.00 | $457.09 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $181.97 Typical High $275.42 | Professional | 53 · Discontinued | $39.81 | $181.97 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $691.83 Typical High $1,047.13 | Professional | 54 · Surgery only | $151.36 | $691.83 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $138.04 Typical High $208.93 | Professional | 55 · Aftercare only | $30.20 | $138.04 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $91.20 Typical High $138.04 | Professional | 56 · Pre-op care only | $19.95 | $91.20 | $138.04 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $1,621.81 Typical High $3,311.31 | Professional | 50 · Both sides | $363.08 | $1,621.81 | $3,311.31 |
Where California sits
The same service costs 6.5 times more in Washington 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· 28th of 51
$1,202
WA $2,138MD $331
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.