How much rates vary
Facilitymedian $1,905 · 10th to 90th $72 to $7,244Professionalmedian $55 · 10th to 90th $44 to $229
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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $43.65 Typical High $3,981.07 | Professional | None | $41.69 | $43.65 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $56.23 Typical High $177.83 | Professional | None | $43.65 | $56.23 | $177.83 |
Blue Shield Setting Facility Modifier None Typical Low $85.11 Median $2,089.30 Typical High $5,623.41 | Facility | None | $85.11 | $2,089.30 | $5,623.41 |
Blue Shield Setting Professional Modifier None Typical Low $38.02 Median $54.95 Typical High $104.71 | Professional | None | $38.02 | $54.95 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $676.08 | Facility | None | $50.12 | $61.66 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $151.36 | Professional | None | $47.86 | $54.95 | $151.36 |
Contra Costa Health Setting Professional Modifier None Typical Low $41.69 Median $51.29 Typical High $60.26 | Professional | None | $41.69 | $51.29 | $60.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $53.70 Typical High $125.89 | Professional | None | $41.69 | $53.70 | $125.89 |
Lucent Health Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $676.08 | Facility | None | $50.12 | $66.07 | $676.08 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $53.70 Typical High $144.54 | Professional | None | $46.77 | $53.70 | $144.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $141.25 | Professional | None | $40.74 | $53.70 | $141.25 |
5 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 Professional Modifier 52 · Reduced service Typical Low $20.89 Median $21.88 Typical High $26.92 | Professional | 52 · Reduced service | $20.89 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.71 Typical High $10.72 | Professional | 53 · Discontinued | $8.32 | $8.71 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $33.11 Typical High $40.74 | Professional | 54 · Surgery only | $31.62 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.61 Typical High $8.13 | Professional | 55 · Aftercare only | $6.31 | $6.61 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.17 | $4.37 | $5.37 |
Where California sits
The same service costs 6.5 times more in Tennessee than in New York. 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· 23rd of 51
$85.11
TN $316NY $48.98
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.