How much rates vary
Facilitymedian $1,905 · 10th to 90th $631 to $9,550Professionalmedian $550 · 10th to 90th $138 to $1,738
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 $660.69 Median $5,128.61 Typical High $15,135.61 | Facility | None | $660.69 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $512.86 Typical High $954.99 | Professional | None | $138.04 | $512.86 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | None | $128.82 | $128.82 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $2,137.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $776.25 Typical High $1,513.56 | Professional | None | $181.97 | $776.25 | $1,513.56 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,290.87 Typical High $14,125.38 | Facility | None | $100.00 | $2,290.87 | $14,125.38 |
Blue Shield Setting Professional Modifier None Typical Low $109.65 Median $426.58 Typical High $758.58 | Professional | None | $109.65 | $426.58 | $758.58 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $173.78 Median $741.31 Typical High $1,023.29 | Professional | None | $173.78 | $741.31 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $954.99 Typical High $1,862.09 | Facility | None | $660.69 | $954.99 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $549.54 Typical High $1,071.52 | Professional | None | $144.54 | $549.54 | $1,071.52 |
Contra Costa Health Setting Professional Modifier None Typical Low $154.88 Median $512.86 Typical High $1,000.00 | Professional | None | $154.88 | $512.86 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $588.84 Typical High $1,202.26 | Professional | None | $144.54 | $588.84 | $1,202.26 |
Lucent Health Setting Professional Modifier None Typical Low $4,786.30 Median $5,888.44 Typical High $5,888.44 | Professional | None | $4,786.30 | $5,888.44 | $5,888.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $575.44 Typical High $954.99 | Professional | None | $33.11 | $575.44 | $954.99 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $912.01 Typical High $1,862.09 | Facility | None | $602.56 | $912.01 | $1,862.09 |
Providence Setting Professional Modifier None Typical Low $144.54 Median $549.54 Typical High $1,071.52 | Professional | None | $144.54 | $549.54 | $1,071.52 |
Sutter Health Plus Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $2,344.23 | Professional | None | $549.54 | $549.54 | $2,344.23 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $141.25 Median $549.54 Typical High $1,202.26 | Professional | None | $141.25 | $549.54 | $1,202.26 |
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 $69.18 Median $70.79 Typical High $331.13 | Facility | 52 · Reduced service | $69.18 | $70.79 | $331.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $27.54 Median $28.18 Typical High $131.83 | Facility | 53 · Discontinued | $27.54 | $28.18 | $131.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $104.71 Median $107.15 Typical High $489.78 | Facility | 54 · Surgery only | $104.71 | $107.15 | $489.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.89 Median $21.38 Typical High $97.72 | Facility | 55 · Aftercare only | $20.89 | $21.38 | $97.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $208.93 Typical High $331.13 | Professional | 52 · Reduced service | $69.18 | $208.93 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $83.18 Typical High $131.83 | Professional | 53 · Discontinued | $27.54 | $83.18 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $309.03 Typical High $489.78 | Professional | 54 · Surgery only | $104.71 | $309.03 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $61.66 Typical High $97.72 | Professional | 55 · Aftercare only | $20.89 | $61.66 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $41.69 Typical High $66.07 | Professional | 56 · Pre-op care only | $13.80 | $41.69 | $66.07 |
Where California sits
The same service costs 5.2 times more in Wisconsin than in Hawaii. 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
$575
WI $1,148HI $219
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.