How much rates vary
Facilitymedian $1,905 · 10th to 90th $72 to $7,244Professionalmedian $45 · 10th to 90th $34 to $617
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 $35.48 Median $37.15 Typical High $3,981.07 | Professional | None | $35.48 | $37.15 | $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 $33.88 Median $38.90 Typical High $154.88 | Professional | None | $33.88 | $38.90 | $154.88 |
Blue Shield Setting Facility Modifier None Typical Low $87.10 Median $2,089.30 Typical High $5,623.41 | Facility | None | $87.10 | $2,089.30 | $5,623.41 |
Blue Shield Setting Professional Modifier None Typical Low $30.90 Median $44.67 Typical High $87.10 | Professional | None | $30.90 | $44.67 | $87.10 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $39.81 Median $72.44 Typical High $112.20 | Professional | None | $39.81 | $72.44 | $112.20 |
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 $37.15 Median $44.67 Typical High $112.20 | Professional | None | $37.15 | $44.67 | $112.20 |
Contra Costa Health Setting Professional Modifier None Typical Low $35.48 Median $47.86 Typical High $75.86 | Professional | None | $35.48 | $47.86 | $75.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $32.36 Median $40.74 Typical High $95.50 | Professional | None | $32.36 | $40.74 | $95.50 |
Lucent Health Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $954.99 | Professional | None | $616.60 | $954.99 | $954.99 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Providence Setting Facility Modifier None Typical Low $40.74 Median $58.88 Typical High $676.08 | Facility | None | $40.74 | $58.88 | $676.08 |
Providence Setting Professional Modifier None Typical Low $37.15 Median $43.65 Typical High $112.20 | Professional | None | $37.15 | $43.65 | $112.20 |
Sutter Health Plus Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,090.30 | Facility | None | $123.03 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $32.36 Median $43.65 Typical High $120.23 | Professional | None | $32.36 | $43.65 | $120.23 |
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 $17.78 Median $18.62 Typical High $22.39 | Professional | 52 · Reduced service | $17.78 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.41 Typical High $8.91 | Professional | 53 · Discontinued | $7.08 | $7.41 | $8.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $28.18 Typical High $33.11 | Professional | 54 · Surgery only | $26.30 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.62 Typical High $6.61 | Professional | 55 · Aftercare only | $5.25 | $5.62 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.72 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.55 | $3.72 | $4.47 |
Where California sits
The same service costs 9.3 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· 18th of 51
$75.86
TN $398NY $42.66
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.