How much rates vary
Facilitymedian $1,660 · 10th to 90th $135 to $9,550Professionalmedian $282 · 10th to 90th $85 to $1,349
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 $478.63 Median $5,128.61 Typical High $15,135.61 | Facility | None | $478.63 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $263.03 Typical High $398.11 | Professional | None | $83.18 | $263.03 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,456.54 Typical High $14,125.38 | Facility | None | $2,884.03 | $6,456.54 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $338.84 Typical High $933.25 | Professional | None | $100.00 | $338.84 | $933.25 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $66.07 Median $204.17 Typical High $426.58 | Professional | None | $66.07 | $204.17 | $426.58 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $75.86 Median $281.84 Typical High $371.54 | Professional | None | $75.86 | $281.84 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,000.00 Typical High $2,691.53 | Facility | None | $630.96 | $1,000.00 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $263.03 Typical High $512.86 | Professional | None | $85.11 | $263.03 | $512.86 |
Contra Costa Health Setting Professional Modifier None Typical Low $87.10 Median $245.47 Typical High $371.54 | Professional | None | $87.10 | $245.47 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $229.09 Typical High $575.44 | Professional | None | $77.62 | $229.09 | $575.44 |
Lucent Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,089.30 | Professional | None | $1,737.80 | $1,737.80 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $346.74 | Professional | None | $208.93 | $208.93 | $346.74 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $691.83 Typical High $2,691.53 | Facility | None | $100.00 | $691.83 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $85.11 Median $263.03 Typical High $512.86 | Professional | None | $85.11 | $263.03 | $512.86 |
Sutter Health Plus Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $954.99 | Professional | None | $281.84 | $281.84 | $954.99 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $3,090.30 | Facility | None | $123.03 | $537.03 | $3,090.30 |
United Setting Professional Modifier None Typical Low $81.28 Median $251.19 Typical High $588.84 | Professional | None | $81.28 | $251.19 | $588.84 |
10 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 $41.69 Median $41.69 Typical High $154.88 | Facility | 52 · Reduced service | $41.69 | $41.69 | $154.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.60 Median $16.98 Typical High $61.66 | Facility | 53 · Discontinued | $16.60 | $16.98 | $61.66 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $61.66 Median $63.10 Typical High $234.42 | Facility | 54 · Surgery only | $61.66 | $63.10 | $234.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $12.59 Typical High $46.77 | Facility | 55 · Aftercare only | $12.30 | $12.59 | $46.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $100.00 Typical High $154.88 | Professional | 52 · Reduced service | $39.81 | $100.00 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $39.81 Typical High $61.66 | Professional | 53 · Discontinued | $15.85 | $39.81 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $147.91 Typical High $234.42 | Professional | 54 · Surgery only | $58.88 | $147.91 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $29.51 Typical High $46.77 | Professional | 55 · Aftercare only | $12.02 | $29.51 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $19.95 Typical High $30.90 | Professional | 56 · Pre-op care only | $7.94 | $19.95 | $30.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $158.49 Median $354.81 Typical High $954.99 | Professional | 50 · Both sides | $158.49 | $354.81 | $954.99 |
Where California sits
The same service costs 3.6 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· 14th of 51
$309
WI $537NE $148
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.