How much rates vary
Facilitymedian $7,586 · 10th to 90th $2,089 to $16,982Professionalmedian $1,318 · 10th to 90th $251 to $6,166
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 $1,445.44 Median $5,888.44 Typical High $15,848.93 | Facility | None | $1,445.44 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $1,318.26 Typical High $1,737.80 | Professional | None | $239.88 | $1,318.26 | $1,737.80 |
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 $363.08 Median $1,318.26 Typical High $3,890.45 | Professional | None | $363.08 | $1,318.26 | $3,890.45 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $4,466.84 Typical High $9,549.93 | Facility | None | $100.00 | $4,466.84 | $9,549.93 |
Blue Shield Setting Professional Modifier None Typical Low $204.17 Median $1,096.48 Typical High $1,995.26 | Professional | None | $204.17 | $1,096.48 | $1,995.26 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $1,862.09 | Professional | None | $229.09 | $338.84 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $1,148.15 Typical High $2,344.23 | Professional | None | $275.42 | $1,148.15 | $2,344.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $1,819.70 | Professional | None | $229.09 | $275.42 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $1,047.13 Typical High $2,137.96 | Professional | None | $213.80 | $1,047.13 | $2,137.96 |
Lucent Health Setting Professional Modifier None Typical Low $8,709.64 Median $10,715.19 Typical High $10,715.19 | Professional | None | $8,709.64 | $10,715.19 | $10,715.19 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $1,023.29 Typical High $1,737.80 | Professional | None | $33.11 | $1,023.29 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $691.83 Typical High $2,344.23 | Facility | None | $251.19 | $691.83 | $2,344.23 |
Providence Setting Professional Modifier None Typical Low $275.42 Median $1,202.26 Typical High $2,290.87 | Professional | None | $275.42 | $1,202.26 | $2,290.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $4,677.35 | Professional | None | $831.76 | $831.76 | $4,677.35 |
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 $223.87 Median $1,148.15 Typical High $2,511.89 | Professional | None | $223.87 | $1,148.15 | $2,511.89 |
9 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 $125.89 Median $131.83 Typical High $851.14 | Facility | 52 · Reduced service | $125.89 | $131.83 | $851.14 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $50.12 Median $53.70 Typical High $338.84 | Facility | 53 · Discontinued | $50.12 | $53.70 | $338.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.02 Median $39.81 Typical High $251.19 | Facility | 55 · Aftercare only | $38.02 | $39.81 | $251.19 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.92 Typical High $169.82 | Facility | 56 · Pre-op care only | $25.12 | $26.92 | $169.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $512.86 Typical High $851.14 | Professional | 52 · Reduced service | $125.89 | $512.86 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $204.17 Typical High $338.84 | Professional | 53 · Discontinued | $50.12 | $204.17 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $776.25 Typical High $1,258.93 | Professional | 54 · Surgery only | $190.55 | $776.25 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $154.88 Typical High $251.19 | Professional | 55 · Aftercare only | $38.02 | $154.88 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $102.33 Typical High $169.82 | Professional | 56 · Pre-op care only | $25.12 | $102.33 | $169.82 |
Where California sits
The same service costs 4.7 times more in Wisconsin than in Nebraska. 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
$1,380
WI $2,089NE $447
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.