How much rates vary
Facilitymedian $1,820 · 10th to 90th $407 to $8,128Professionalmedian $204 · 10th to 90th $105 to $1,230
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 $645.65 Median $5,888.44 Typical High $15,848.93 | Facility | None | $645.65 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $186.21 Typical High $331.13 | Professional | None | $102.33 | $186.21 | $331.13 |
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 $138.04 Median $257.04 Typical High $724.44 | Professional | None | $138.04 | $257.04 | $724.44 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $7,244.36 | Facility | None | $100.00 | $2,137.96 | $7,244.36 |
Blue Shield Setting Professional Modifier None Typical Low $91.20 Median $151.36 Typical High $302.00 | Professional | None | $91.20 | $151.36 | $302.00 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $91.20 Median $112.20 Typical High $363.08 | Professional | None | $91.20 | $112.20 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,047.13 Typical High $1,862.09 | Facility | None | $575.44 | $1,047.13 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $190.55 Typical High $407.38 | Professional | None | $104.71 | $190.55 | $407.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $100.00 Median $323.59 Typical High $389.05 | Professional | None | $100.00 | $323.59 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $269.15 Typical High $524.81 | Professional | None | $97.72 | $269.15 | $524.81 |
Lucent Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,659.59 | $1,659.59 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $323.59 | Professional | None | $194.98 | $194.98 | $323.59 |
Providence Setting Facility Modifier None Typical Low $269.15 Median $1,047.13 Typical High $3,311.31 | Facility | None | $269.15 | $1,047.13 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $104.71 Median $186.21 Typical High $407.38 | Professional | None | $104.71 | $186.21 | $407.38 |
Sutter Health Plus Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $812.83 | Professional | None | $354.81 | $354.81 | $812.83 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,230.27 Typical High $4,786.30 | Facility | None | $398.11 | $1,230.27 | $4,786.30 |
United Setting Professional Modifier None Typical Low $97.72 Median $213.80 Typical High $524.81 | Professional | None | $97.72 | $213.80 | $524.81 |
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 $51.29 Median $53.70 Typical High $112.20 | Facility | 52 · Reduced service | $51.29 | $53.70 | $112.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $21.38 Typical High $44.67 | Facility | 53 · Discontinued | $20.42 | $21.38 | $44.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $77.62 Median $81.28 Typical High $169.82 | Facility | 54 · Surgery only | $77.62 | $81.28 | $169.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.49 Median $16.22 Typical High $33.88 | Facility | 55 · Aftercare only | $15.49 | $16.22 | $33.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.72 Typical High $22.39 | Facility | 56 · Pre-op care only | $10.23 | $10.72 | $22.39 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $89.13 Typical High $112.20 | Professional | 52 · Reduced service | $47.86 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $35.48 Typical High $44.67 | Professional | 53 · Discontinued | $19.50 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $131.83 Typical High $169.82 | Professional | 54 · Surgery only | $72.44 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $26.30 Typical High $33.88 | Professional | 55 · Aftercare only | $14.45 | $26.30 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $17.78 Typical High $22.39 | Professional | 56 · Pre-op care only | $9.77 | $17.78 | $22.39 |
Where California sits
The same service costs 4.3 times more in Alaska 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· 31st of 51
$269
AK $776KY $182
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.