How much rates vary
Facilitymedian $3,715 · 10th to 90th $589 to $11,220Professionalmedian $155 · 10th to 90th $115 to $851
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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $141.25 | Professional | None | $120.23 | $134.90 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $10,000.00 | Facility | None | $2,137.96 | $4,786.30 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $416.87 | Professional | None | $131.83 | $165.96 | $416.87 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $269.15 | Professional | None | $109.65 | $158.49 | $269.15 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $158.49 | Professional | None | $109.65 | $131.83 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $288.40 | Professional | None | $128.82 | $147.91 | $288.40 |
Contra Costa Health Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $162.18 | Professional | None | $85.11 | $120.23 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $245.47 | Professional | None | $100.00 | $123.03 | $245.47 |
Lucent Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $186.21 | Professional | None | $33.11 | $33.11 | $186.21 |
Providence Setting Facility Modifier None Typical Low $134.90 Median $194.98 Typical High $269.15 | Facility | None | $134.90 | $194.98 | $269.15 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $281.84 | Professional | None | $128.82 | $144.54 | $281.84 |
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 $602.56 Median $1,698.24 Typical High $7,244.36 | Facility | None | $602.56 | $1,698.24 | $7,244.36 |
United Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $269.15 | Professional | None | $104.71 | $138.04 | $269.15 |
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 $60.26 Median $67.61 Typical High $70.79 | Professional | 52 · Reduced service | $60.26 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $26.92 Typical High $28.84 | Professional | 53 · Discontinued | $23.99 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $102.33 Typical High $107.15 | Professional | 54 · Surgery only | $91.20 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $20.42 Typical High $21.38 | Professional | 55 · Aftercare only | $18.20 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.49 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.02 | $13.49 | $14.13 |
Where California sits
The same service costs 3.7 times more in Alaska 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· 37th of 51
$158
AK $447NY $120
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.