How much rates vary
Facilitymedian $1,047 · 10th to 90th $117 to $5,754Professionalmedian $65 · 10th to 90th $40 to $234
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 $46.77 Median $50.12 Typical High $50.12 | Facility | None | $46.77 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $46.77 Typical High $50.12 | Professional | None | $43.65 | $46.77 | $50.12 |
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 $57.54 Median $67.61 Typical High $194.98 | Professional | None | $57.54 | $67.61 | $194.98 |
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 $29.51 Median $41.69 Typical High $107.15 | Professional | None | $29.51 | $41.69 | $107.15 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $40.74 Median $48.98 Typical High $48.98 | Professional | None | $40.74 | $48.98 | $48.98 |
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 $46.77 Median $54.95 Typical High $134.90 | Professional | None | $46.77 | $54.95 | $134.90 |
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 $39.81 Median $60.26 Typical High $123.03 | Professional | None | $39.81 | $60.26 | $123.03 |
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 $67.61 Median $1,318.26 Typical High $5,623.41 | Facility | None | $67.61 | $1,318.26 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $53.70 Typical High $134.90 | Professional | None | $44.67 | $53.70 | $134.90 |
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 $37.15 Median $50.12 Typical High $165.96 | Professional | None | $37.15 | $50.12 | $165.96 |
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 $21.88 Median $23.44 Typical High $25.12 | Professional | 52 · Reduced service | $21.88 | $23.44 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.33 Typical High $10.00 | Professional | 53 · Discontinued | $8.71 | $9.33 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.08 Typical High $7.59 | Professional | 55 · Aftercare only | $6.61 | $7.08 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.68 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.37 | $4.68 | $5.01 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $56.23 Median $70.79 Typical High $112.20 | Professional | 50 · Both sides | $56.23 | $70.79 | $112.20 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $23.44 Median $30.20 Typical High $46.77 | Professional | 62 · Two surgeons | $23.44 | $30.20 | $46.77 |
Where California sits
The same service costs 4.7 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· 30th of 51
$70.79
WI $200KY $42.66
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.