How much rates vary
Facilitymedian $1,047 · 10th to 90th $117 to $5,754Professionalmedian $98 · 10th to 90th $60 to $355
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 $70.79 Median $75.86 Typical High $75.86 | Facility | None | $70.79 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $70.79 Typical High $75.86 | Professional | None | $66.07 | $70.79 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $295.12 | Professional | None | $64.57 | $100.00 | $295.12 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $1,000.00 Typical High $4,570.88 | Facility | None | $97.72 | $1,000.00 | $4,570.88 |
Blue Shield Setting Professional Modifier None Typical Low $44.67 Median $64.57 Typical High $162.18 | Professional | None | $44.67 | $64.57 | $162.18 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $74.13 | Professional | None | $61.66 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $870.96 Typical High $5,623.41 | Facility | None | $426.58 | $870.96 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $199.53 | Professional | None | $67.61 | $81.28 | $199.53 |
Contra Costa Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $91.20 Typical High $186.21 | Professional | None | $60.26 | $91.20 | $186.21 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Providence Setting Facility Modifier None Typical Low $97.72 Median $1,318.26 Typical High $5,623.41 | Facility | None | $97.72 | $1,318.26 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $204.17 | Professional | None | $67.61 | $79.43 | $204.17 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,090.30 | Facility | None | $123.03 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $251.19 | Professional | None | $56.23 | $75.86 | $251.19 |
6 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 $33.11 Median $35.48 Typical High $38.02 | Professional | 52 · Reduced service | $33.11 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.45 Typical High $15.14 | Professional | 53 · Discontinued | $13.49 | $14.45 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.72 Typical High $11.48 | Professional | 55 · Aftercare only | $10.00 | $10.72 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.08 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.61 | $7.08 | $7.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $85.11 Median $107.15 Typical High $147.91 | Professional | 50 · Both sides | $85.11 | $107.15 | $147.91 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $35.48 Median $45.71 Typical High $63.10 | Professional | 62 · Two surgeons | $35.48 | $45.71 | $63.10 |
Where California sits
The same service costs 4.5 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
$102
WI $288KY $64.57
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.