How much rates vary
Facilitymedian $417 · 10th to 90th $21 to $6,166Professionalmedian $31 · 10th to 90th $14 to $100
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 $14.45 Median $28.84 Typical High $39.81 | Facility | None | $14.45 | $28.84 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $27.54 Typical High $34.67 | Professional | None | $13.49 | $27.54 | $34.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,897.79 Typical High $10,000.00 | Facility | None | $2,137.96 | $4,897.79 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.78 Median $36.31 Typical High $87.10 | Professional | None | $17.78 | $36.31 | $87.10 |
Blue Shield Setting Facility Modifier None Typical Low $31.62 Median $302.00 Typical High $776.25 | Facility | None | $31.62 | $302.00 | $776.25 |
Blue Shield Setting Professional Modifier None Typical Low $15.49 Median $25.70 Typical High $48.98 | Professional | None | $15.49 | $25.70 | $48.98 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $11.75 Median $20.89 Typical High $38.90 | Professional | None | $11.75 | $20.89 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $676.08 | Facility | None | $50.12 | $61.66 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $30.20 Typical High $53.70 | Professional | None | $15.14 | $30.20 | $53.70 |
Contra Costa Health Setting Professional Modifier None Typical Low $12.59 Median $15.85 Typical High $38.02 | Professional | None | $12.59 | $15.85 | $38.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $13.18 Median $28.84 Typical High $53.70 | Professional | None | $13.18 | $28.84 | $53.70 |
Lucent Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $234.42 | Professional | None | $199.53 | $199.53 | $234.42 |
Molina Setting Professional Modifier None Typical Low $22.91 Median $33.11 Typical High $38.02 | Professional | None | $22.91 | $33.11 | $38.02 |
Providence Setting Facility Modifier None Typical Low $13.49 Median $33.88 Typical High $75.86 | Facility | None | $13.49 | $33.88 | $75.86 |
Providence Setting Professional Modifier None Typical Low $15.14 Median $30.20 Typical High $53.70 | Professional | None | $15.14 | $30.20 | $53.70 |
Sutter Health Plus Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $100.00 | Professional | None | $51.29 | $51.29 | $100.00 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $13.80 Median $28.18 Typical High $61.66 | Professional | None | $13.80 | $28.18 | $61.66 |
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 $7.24 Median $10.00 Typical High $17.38 | Facility | 52 · Reduced service | $7.24 | $10.00 | $17.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.95 Median $3.98 Typical High $6.92 | Facility | 53 · Discontinued | $2.95 | $3.98 | $6.92 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $10.96 Median $14.79 Typical High $25.70 | Facility | 54 · Surgery only | $10.96 | $14.79 | $25.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.19 Median $3.02 Typical High $5.13 | Facility | 55 · Aftercare only | $2.19 | $3.02 | $5.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.45 Median $2.00 Typical High $3.47 | Facility | 56 · Pre-op care only | $1.45 | $2.00 | $3.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.92 Median $12.30 Typical High $17.38 | Professional | 52 · Reduced service | $6.92 | $12.30 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $4.90 Typical High $6.92 | Professional | 53 · Discontinued | $2.75 | $4.90 | $6.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.47 Median $18.20 Typical High $25.70 | Professional | 54 · Surgery only | $10.47 | $18.20 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $3.63 Typical High $5.13 | Professional | 55 · Aftercare only | $2.09 | $3.63 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $2.45 Typical High $3.47 | Professional | 56 · Pre-op care only | $1.38 | $2.45 | $3.47 |
Where California sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 35th of 51
$32.36
WI $87.10KY $25.12
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.