How much rates vary
Facilitymedian $813 · 10th to 90th $151 to $9,120Professionalmedian $141 · 10th to 90th $102 to $389
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 $109.65 Median $120.23 Typical High $162.18 | Professional | None | $109.65 | $120.23 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $7,943.28 Typical High $16,982.44 | Facility | None | $3,630.78 | $7,943.28 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $251.19 | Professional | None | $125.89 | $186.21 | $251.19 |
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 $95.50 Median $134.90 Typical High $165.96 | Professional | None | $95.50 | $134.90 | $165.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $204.17 | Professional | None | $128.82 | $128.82 | $204.17 |
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 $117.49 Median $128.82 Typical High $190.55 | Professional | None | $117.49 | $128.82 | $190.55 |
Contra Costa Health Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $144.54 | Professional | None | $114.82 | $123.03 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $251.19 | Professional | None | $102.33 | $114.82 | $251.19 |
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 $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $117.49 Median $125.89 Typical High $190.55 | Professional | None | $117.49 | $125.89 | $190.55 |
Sutter Health Plus Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $100.00 Median $125.89 Typical High $190.55 | Professional | None | $100.00 | $125.89 | $190.55 |
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 $54.95 Median $57.54 Typical High $67.61 | Professional | 52 · Reduced service | $54.95 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.91 Typical High $26.92 | Professional | 53 · Discontinued | $21.88 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $85.11 Typical High $100.00 | Professional | 54 · Surgery only | $81.28 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.38 Typical High $19.95 | Professional | 55 · Aftercare only | $16.22 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.48 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.96 | $11.48 | $13.49 |
Where California sits
The same service costs 5.1 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· 38th of 51
$145
AK $501UT $97.72
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.