How much rates vary
Facilitymedian $5,129 · 10th to 90th $646 to $13,804Professionalmedian $1,122 · 10th to 90th $229 to $4,571
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 $1,288.25 Median $5,754.40 Typical High $15,848.93 | Facility | None | $1,288.25 | $5,754.40 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $741.31 Typical High $1,479.11 | Professional | None | $218.78 | $741.31 | $1,479.11 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $1,288.25 | Professional | None | $114.82 | $208.93 | $1,288.25 |
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 $331.13 Median $1,023.29 Typical High $2,570.40 | Professional | None | $331.13 | $1,023.29 | $2,570.40 |
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 $186.21 Median $831.76 Typical High $1,548.82 | Professional | None | $186.21 | $831.76 | $1,548.82 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $1,819.70 | Professional | None | $239.88 | $346.74 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $776.25 Typical High $2,187.76 | Professional | None | $245.47 | $776.25 | $2,187.76 |
Contra Costa Health Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $1,778.28 | Professional | None | $204.17 | $257.04 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $1,000.00 Typical High $2,089.30 | Professional | None | $194.98 | $1,000.00 | $2,089.30 |
Lucent Health Setting Professional Modifier None Typical Low $8,511.38 Median $10,471.29 Typical High $10,471.29 | Professional | None | $8,511.38 | $10,471.29 | $10,471.29 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,000.00 Typical High $1,659.59 | Professional | None | $33.11 | $1,000.00 | $1,659.59 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $501.19 Typical High $2,089.30 | Facility | None | $251.19 | $501.19 | $2,089.30 |
Providence Setting Professional Modifier None Typical Low $239.88 Median $776.25 Typical High $2,089.30 | Professional | None | $239.88 | $776.25 | $2,089.30 |
Sutter Health Plus Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $4,570.88 | Professional | None | $758.58 | $758.58 | $4,570.88 |
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 $208.93 Median $1,047.13 Typical High $2,344.23 | Professional | None | $208.93 | $1,047.13 | $2,344.23 |
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 $120.23 Median $125.89 Typical High $741.31 | Facility | 52 · Reduced service | $120.23 | $125.89 | $741.31 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $47.86 Median $50.12 Typical High $295.12 | Facility | 53 · Discontinued | $47.86 | $50.12 | $295.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $181.97 Median $190.55 Typical High $1,096.48 | Facility | 54 · Surgery only | $181.97 | $190.55 | $1,096.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $36.31 Median $38.02 Typical High $218.78 | Facility | 55 · Aftercare only | $36.31 | $38.02 | $218.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.12 Typical High $147.91 | Facility | 56 · Pre-op care only | $23.99 | $25.12 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $501.19 Typical High $741.31 | Professional | 52 · Reduced service | $120.23 | $501.19 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $199.53 Typical High $295.12 | Professional | 53 · Discontinued | $47.86 | $199.53 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $741.31 Typical High $1,096.48 | Professional | 54 · Surgery only | $181.97 | $741.31 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $147.91 Typical High $218.78 | Professional | 55 · Aftercare only | $36.31 | $147.91 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $100.00 Typical High $147.91 | Professional | 56 · Pre-op care only | $23.99 | $100.00 | $147.91 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $1,698.24 Typical High $2,754.23 | Professional | 50 · Both sides | $380.19 | $1,698.24 | $2,754.23 |
Where California sits
The same service costs 5.8 times more in Washington than in Hawaii. 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· 21st of 51
$1,122
WA $1,820HI $316
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.