How much rates vary
Facilitymedian $5,129 · 10th to 90th $646 to $13,804Professionalmedian $891 · 10th to 90th $251 to $2,138
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 $239.88 Median $912.01 Typical High $1,445.44 | Professional | None | $239.88 | $912.01 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $263.03 Typical High $263.03 | Professional | None | $245.47 | $263.03 | $263.03 |
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 $371.54 Median $933.25 Typical High $2,398.83 | Professional | None | $371.54 | $933.25 | $2,398.83 |
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 $234.42 Median $1,047.13 Typical High $1,949.84 | Professional | None | $234.42 | $1,047.13 | $1,949.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $1,174.90 | Professional | None | $251.19 | $416.87 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $724.44 Typical High $1,621.81 | Professional | None | $263.03 | $724.44 | $1,621.81 |
Contra Costa Health Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $1,148.15 | Professional | None | $223.87 | $295.12 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $676.08 Typical High $1,348.96 | Professional | None | $204.17 | $676.08 | $1,348.96 |
Lucent Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $676.08 Typical High $1,122.02 | Professional | None | $33.11 | $676.08 | $1,122.02 |
Providence Setting Facility Modifier None Typical Low $281.84 Median $537.03 Typical High $1,995.26 | Facility | None | $281.84 | $537.03 | $1,995.26 |
Providence Setting Professional Modifier None Typical Low $263.03 Median $724.44 Typical High $1,621.81 | Professional | None | $263.03 | $724.44 | $1,621.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $2,884.03 | Professional | None | $812.83 | $812.83 | $2,884.03 |
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 $218.78 Median $707.95 Typical High $1,621.81 | Professional | None | $218.78 | $707.95 | $1,621.81 |
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 $131.83 Median $138.04 Typical High $741.31 | Facility | 52 · Reduced service | $131.83 | $138.04 | $741.31 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $53.70 Median $54.95 Typical High $295.12 | Facility | 53 · Discontinued | $53.70 | $54.95 | $295.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $199.53 Median $204.17 Typical High $1,096.48 | Facility | 54 · Surgery only | $199.53 | $204.17 | $1,096.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $39.81 Median $41.69 Typical High $223.87 | Facility | 55 · Aftercare only | $39.81 | $41.69 | $223.87 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.30 Median $27.54 Typical High $147.91 | Facility | 56 · Pre-op care only | $26.30 | $27.54 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $316.23 Typical High $645.65 | Professional | 52 · Reduced service | $128.82 | $316.23 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $125.89 Typical High $257.04 | Professional | 53 · Discontinued | $52.48 | $125.89 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $478.63 Typical High $977.24 | Professional | 54 · Surgery only | $194.98 | $478.63 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $95.50 Typical High $194.98 | Professional | 55 · Aftercare only | $38.90 | $95.50 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $63.10 Typical High $128.82 | Professional | 56 · Pre-op care only | $26.30 | $63.10 | $128.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $1,288.25 Typical High $1,995.26 | Professional | 50 · Both sides | $398.11 | $1,288.25 | $1,995.26 |
Where California sits
The same service costs 4.3 times more in Wisconsin 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· 12th of 51
$912
WI $1,380HI $324
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.