How much rates vary
Facilitymedian $2,188 · 10th to 90th $363 to $6,607Professionalmedian $251 · 10th to 90th $105 to $724
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 $380.19 Median $5,128.61 Typical High $15,135.61 | Facility | None | $380.19 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $234.42 Typical High $371.54 | Professional | None | $89.13 | $234.42 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,011.87 Typical High $10,000.00 | Facility | None | $2,137.96 | $5,011.87 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $346.74 Typical High $776.25 | Professional | None | $162.18 | $346.74 | $776.25 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $707.95 Typical High $4,786.30 | Facility | None | $100.00 | $707.95 | $4,786.30 |
Blue Shield Setting Professional Modifier None Typical Low $102.33 Median $239.88 Typical High $467.74 | Professional | None | $102.33 | $239.88 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $2,398.83 Typical High $3,981.07 | Facility | None | $436.52 | $2,398.83 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $229.09 Typical High $371.54 | Professional | None | $109.65 | $229.09 | $371.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $331.13 | Professional | None | $87.10 | $109.65 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $229.09 Typical High $512.86 | Professional | None | $81.28 | $229.09 | $512.86 |
Lucent Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $263.03 | Professional | None | $154.88 | $154.88 | $263.03 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $2,344.23 Typical High $4,168.69 | Facility | None | $288.40 | $2,344.23 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $109.65 Median $218.78 Typical High $371.54 | Professional | None | $109.65 | $218.78 | $371.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $630.96 | Professional | None | $275.42 | $275.42 | $630.96 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,230.27 Typical High $5,011.87 | Facility | None | $398.11 | $1,230.27 | $5,011.87 |
United Setting Professional Modifier None Typical Low $83.18 Median $190.55 Typical High $467.74 | Professional | None | $83.18 | $190.55 | $467.74 |
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 $57.54 Median $60.26 Typical High $151.36 | Facility | 52 · Reduced service | $57.54 | $60.26 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.91 Median $23.99 Typical High $60.26 | Facility | 53 · Discontinued | $22.91 | $23.99 | $60.26 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $87.10 Median $89.13 Typical High $229.09 | Facility | 54 · Surgery only | $87.10 | $89.13 | $229.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.38 Median $17.78 Typical High $45.71 | Facility | 55 · Aftercare only | $17.38 | $17.78 | $45.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.02 Typical High $30.20 | Facility | 56 · Pre-op care only | $11.48 | $12.02 | $30.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $89.13 Typical High $138.04 | Professional | 52 · Reduced service | $54.95 | $89.13 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $35.48 Typical High $54.95 | Professional | 53 · Discontinued | $21.88 | $35.48 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $134.90 Typical High $204.17 | Professional | 54 · Surgery only | $83.18 | $134.90 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $26.92 Typical High $40.74 | Professional | 55 · Aftercare only | $16.60 | $26.92 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $17.78 Typical High $27.54 | Professional | 56 · Pre-op care only | $10.96 | $17.78 | $27.54 |
Where California sits
The same service costs 4.1 times more in Alaska 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
$331
AK $646NE $158
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.