How much rates vary
Facilitymedian $3,802 · 10th to 90th $224 to $11,482Professionalmedian $132 · 10th to 90th $48 to $309
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 $204.17 Median $5,754.40 Typical High $15,848.93 | Facility | None | $204.17 | $5,754.40 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $117.49 Typical High $194.98 | Professional | None | $45.71 | $117.49 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $79.43 | Professional | None | $42.66 | $42.66 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $10,000.00 | Facility | None | $2,137.96 | $4,786.30 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $144.54 Typical High $331.13 | Professional | None | $69.18 | $144.54 | $331.13 |
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 $44.67 Median $138.04 Typical High $257.04 | Professional | None | $44.67 | $138.04 | $257.04 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $48.98 Median $77.62 Typical High $162.18 | Professional | None | $48.98 | $77.62 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $120.23 Typical High $239.88 | Professional | None | $48.98 | $120.23 | $239.88 |
Contra Costa Health Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $158.49 | Professional | None | $43.65 | $54.95 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $107.15 Typical High $199.53 | Professional | None | $39.81 | $107.15 | $199.53 |
Lucent Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $95.50 Typical High $158.49 | Professional | None | $33.11 | $95.50 | $158.49 |
Providence Setting Facility Modifier None Typical Low $52.48 Median $100.00 Typical High $263.03 | Facility | None | $52.48 | $100.00 | $263.03 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $123.03 Typical High $239.88 | Professional | None | $48.98 | $123.03 | $239.88 |
Sutter Health Plus Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $457.09 | Professional | None | $158.49 | $158.49 | $457.09 |
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 $42.66 Median $114.82 Typical High $245.47 | Professional | None | $42.66 | $114.82 | $245.47 |
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 $25.12 Median $26.30 Typical High $95.50 | Facility | 52 · Reduced service | $25.12 | $26.30 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.00 Median $10.47 Typical High $38.02 | Facility | 53 · Discontinued | $10.00 | $10.47 | $38.02 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $38.02 Median $38.90 Typical High $141.25 | Facility | 54 · Surgery only | $38.02 | $38.90 | $141.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.59 Median $7.76 Typical High $28.18 | Facility | 55 · Aftercare only | $7.59 | $7.76 | $28.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.25 Typical High $19.05 | Facility | 56 · Pre-op care only | $5.01 | $5.25 | $19.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $54.95 Typical High $83.18 | Professional | 52 · Reduced service | $25.12 | $54.95 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $21.88 Typical High $33.88 | Professional | 53 · Discontinued | $10.00 | $21.88 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $81.28 Typical High $125.89 | Professional | 54 · Surgery only | $38.02 | $81.28 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $16.22 Typical High $25.12 | Professional | 55 · Aftercare only | $7.59 | $16.22 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $10.96 Typical High $16.98 | Professional | 56 · Pre-op care only | $5.01 | $10.96 | $16.98 |
Where California sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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· 19th of 51
$135
WI $234FL $85.11
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.