How much rates vary
Facilitymedian $4,266 · 10th to 90th $427 to $16,218Professionalmedian $178 · 10th to 90th $117 to $3,467
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 $2,570.40 Median $8,912.51 Typical High $19,054.61 | Facility | None | $2,570.40 | $8,912.51 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $2,290.87 | Professional | None | $117.49 | $117.49 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $13,182.57 Typical High $23,442.29 | Facility | None | $5,011.87 | $13,182.57 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $660.69 | Professional | None | $151.36 | $165.96 | $660.69 |
Blue Shield Setting Facility Modifier None Typical Low $72.44 Median $3,467.37 Typical High $7,079.46 | Facility | None | $72.44 | $3,467.37 | $7,079.46 |
Blue Shield Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $371.54 | Professional | None | $102.33 | $147.91 | $371.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $194.98 | Professional | None | $131.83 | $186.21 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $426.58 | Professional | None | $295.12 | $295.12 | $426.58 |
Contra Costa Health Setting Professional Modifier None Typical Low $104.71 Median $173.78 Typical High $208.93 | Professional | None | $104.71 | $173.78 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $457.09 | Professional | None | $154.88 | $190.55 | $457.09 |
Lucent Health Setting Professional Modifier None Typical Low $3,467.37 Median $74,131.02 Typical High $74,131.02 | Professional | None | $3,467.37 | $74,131.02 | $74,131.02 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Providence Setting Facility Modifier None Typical Low $123.03 Median $181.97 Typical High $295.12 | Facility | None | $123.03 | $181.97 | $295.12 |
Providence Setting Professional Modifier None Typical Low $151.36 Median $302.00 Typical High $467.74 | Professional | None | $151.36 | $302.00 | $467.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
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 $117.49 Median $181.97 Typical High $524.81 | Professional | None | $117.49 | $181.97 | $524.81 |
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 $58.88 Median $58.88 Typical High $79.43 | Professional | 52 · Reduced service | $58.88 | $58.88 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $31.62 | Professional | 53 · Discontinued | $23.44 | $23.44 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | 54 · Surgery only | $87.10 | $87.10 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $23.99 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $15.85 |
Where California sits
The same service costs 11.9 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $6,102MT $514
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.