How much rates vary
Facilitymedian $813 · 10th to 90th $155 to $6,761Professionalmedian $148 · 10th to 90th $105 to $525
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 $104.71 Median $109.65 Typical High $186.21 | Professional | None | $104.71 | $109.65 | $186.21 |
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 $158.49 Median $165.96 Typical High $257.04 | Professional | None | $158.49 | $165.96 | $257.04 |
Blue Shield Setting Facility Modifier None Typical Low $72.44 Median $2,570.40 Typical High $6,309.57 | Facility | None | $72.44 | $2,570.40 | $6,309.57 |
Blue Shield Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $151.36 | Professional | None | $89.13 | $125.89 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $457.09 Typical High $891.25 | Facility | None | $323.59 | $457.09 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $257.04 | Professional | None | $112.20 | $117.49 | $257.04 |
Contra Costa Health Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $177.83 | Professional | None | $131.83 | $158.49 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $331.13 | Professional | None | $134.90 | $151.36 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $275.42 Median $478.63 Typical High $2,754.23 | Facility | None | $275.42 | $478.63 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $251.19 | Professional | None | $112.20 | $117.49 | $251.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $109.65 Median $144.54 Typical High $269.15 | Professional | None | $109.65 | $144.54 | $269.15 |
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 $52.48 Median $54.95 Typical High $85.11 | Professional | 52 · Reduced service | $52.48 | $54.95 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.88 Typical High $33.88 | Professional | 53 · Discontinued | $20.89 | $21.88 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $81.28 Typical High $125.89 | Professional | 54 · Surgery only | $77.62 | $81.28 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.22 Typical High $25.70 | Professional | 55 · Aftercare only | $15.49 | $16.22 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.96 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.47 | $10.96 | $16.98 |
Where California sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 47th of 51
$151
AK $603UT $132
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.