How much rates vary
Facilitymedian $4,786 · 10th to 90th $794 to $12,589Professionalmedian $200 · 10th to 90th $132 to $646
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 $2,238.72 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,238.72 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $204.17 | Professional | None | $147.91 | $165.96 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,511.38 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $575.44 | Professional | None | $177.83 | $229.09 | $575.44 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,344.23 Typical High $8,317.64 | Facility | None | $100.00 | $2,344.23 | $8,317.64 |
Blue Shield Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $354.81 | Professional | None | $128.82 | $186.21 | $354.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $141.25 | Professional | None | $114.82 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,677.35 Typical High $7,943.28 | Facility | None | $645.65 | $4,677.35 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $398.11 | Professional | None | $128.82 | $162.18 | $398.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $169.82 | Professional | None | $125.89 | $141.25 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $338.84 | Professional | None | $114.82 | $144.54 | $338.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Providence Setting Facility Modifier None Typical Low $512.86 Median $4,365.16 Typical High $7,943.28 | Facility | None | $512.86 | $4,365.16 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $398.11 | Professional | None | $123.03 | $162.18 | $398.11 |
Sutter Health Plus Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $19,054.61 | Facility | None | $2,884.03 | $6,760.83 | $19,054.61 |
United Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $426.58 | Professional | None | $112.20 | $162.18 | $426.58 |
5 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 Professional Modifier 52 · Reduced service Typical Low $67.61 Median $74.13 Typical High $77.62 | Professional | 52 · Reduced service | $67.61 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $29.51 Typical High $30.90 | Professional | 53 · Discontinued | $26.92 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $109.65 Typical High $117.49 | Professional | 54 · Surgery only | $102.33 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $22.39 Typical High $23.44 | Professional | 55 · Aftercare only | $20.42 | $22.39 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.79 Typical High $15.49 | Professional | 56 · Pre-op care only | $13.49 | $14.79 | $15.49 |
Where California sits
The same service costs 20.4 times more in Kansas than in New York. 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· 16th of 51
$363
KS $3,020NY $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.