How much rates vary
Facilitymedian $1,549 · 10th to 90th $417 to $8,128Professionalmedian $427 · 10th to 90th $89 to $1,905
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 $389.05 Typical High $676.08 | Professional | None | $83.18 | $389.05 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,606.93 Typical High $14,125.38 | Facility | None | $2,884.03 | $6,606.93 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $562.34 Typical High $1,445.44 | Professional | None | $114.82 | $562.34 | $1,445.44 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $2,818.38 Typical High $6,456.54 | Facility | None | $69.18 | $2,818.38 | $6,456.54 |
Blue Shield Setting Professional Modifier None Typical Low $74.13 Median $316.23 Typical High $660.69 | Professional | None | $74.13 | $316.23 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $676.08 Typical High $2,570.40 | Facility | None | $457.09 | $676.08 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $407.38 Typical High $724.44 | Professional | None | $91.20 | $407.38 | $724.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $85.11 Median $389.05 Typical High $588.84 | Professional | None | $85.11 | $389.05 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $354.81 Typical High $758.58 | Professional | None | $74.13 | $354.81 | $758.58 |
Lucent Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,630.27 | $3,162.28 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $501.19 | Professional | None | $302.00 | $302.00 | $501.19 |
Providence Setting Facility Modifier None Typical Low $416.87 Median $707.95 Typical High $5,623.41 | Facility | None | $416.87 | $707.95 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $316.23 Typical High $707.95 | Professional | None | $91.20 | $316.23 | $707.95 |
Sutter Health Plus Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $1,479.11 | Professional | None | $295.12 | $295.12 | $1,479.11 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $4,786.30 | Facility | None | $398.11 | $1,202.26 | $4,786.30 |
United Setting Professional Modifier None Typical Low $81.28 Median $363.08 Typical High $851.14 | Professional | None | $81.28 | $363.08 | $851.14 |
9 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 $44.67 Median $45.71 Typical High $239.88 | Facility | 52 · Reduced service | $44.67 | $45.71 | $239.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.78 Median $18.62 Typical High $95.50 | Facility | 53 · Discontinued | $17.78 | $18.62 | $95.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $13.80 Typical High $72.44 | Facility | 55 · Aftercare only | $13.49 | $13.80 | $72.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.33 Typical High $47.86 | Facility | 56 · Pre-op care only | $8.91 | $9.33 | $47.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $154.88 Typical High $239.88 | Professional | 52 · Reduced service | $42.66 | $154.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $63.10 Typical High $95.50 | Professional | 53 · Discontinued | $16.98 | $63.10 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $234.42 Typical High $363.08 | Professional | 54 · Surgery only | $64.57 | $234.42 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $46.77 Typical High $72.44 | Professional | 55 · Aftercare only | $12.88 | $46.77 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $30.90 Typical High $47.86 | Professional | 56 · Pre-op care only | $8.51 | $30.90 | $47.86 |
Where California sits
The same service costs 7.8 times more in Oklahoma 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· 12th of 51
$490
OK $1,148NE $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.