How much rates vary
Facilitymedian $1,047 · 10th to 90th $93 to $6,310Professionalmedian $95 · 10th to 90th $32 to $339
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 $131.83 Median $5,011.87 Typical High $15,135.61 | Facility | None | $131.83 | $5,011.87 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $95.50 Typical High $177.83 | Professional | None | $30.90 | $95.50 | $177.83 |
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 $35.48 Median $107.15 Typical High $263.03 | Professional | None | $35.48 | $107.15 | $263.03 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,548.82 Typical High $4,897.79 | Facility | None | $100.00 | $1,548.82 | $4,897.79 |
Blue Shield Setting Professional Modifier None Typical Low $27.54 Median $69.18 Typical High $151.36 | Professional | None | $27.54 | $69.18 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $144.54 Typical High $302.00 | Facility | None | $53.70 | $144.54 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $97.72 Typical High $190.55 | Professional | None | $32.36 | $97.72 | $190.55 |
Contra Costa Health Setting Professional Modifier None Typical Low $35.48 Median $128.82 Typical High $165.96 | Professional | None | $35.48 | $128.82 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $31.62 Median $100.00 Typical High $213.80 | Professional | None | $31.62 | $100.00 | $213.80 |
Lucent Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $870.96 | Professional | None | $851.14 | $851.14 | $870.96 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $134.90 | Professional | None | $81.28 | $81.28 | $134.90 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $141.25 Typical High $602.56 | Facility | None | $50.12 | $141.25 | $602.56 |
Providence Setting Professional Modifier None Typical Low $32.36 Median $93.33 Typical High $194.98 | Professional | None | $32.36 | $93.33 | $194.98 |
Sutter Health Plus Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $338.84 | Professional | None | $100.00 | $100.00 | $338.84 |
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 $26.30 Median $87.10 Typical High $218.78 | Professional | None | $26.30 | $87.10 | $218.78 |
10 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 $15.14 Median $18.20 Typical High $66.07 | Facility | 52 · Reduced service | $15.14 | $18.20 | $66.07 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.17 Median $7.24 Typical High $26.30 | Facility | 53 · Discontinued | $6.17 | $7.24 | $26.30 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $22.91 Median $26.92 Typical High $100.00 | Facility | 54 · Surgery only | $22.91 | $26.92 | $100.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.57 Median $5.50 Typical High $19.95 | Facility | 55 · Aftercare only | $4.57 | $5.50 | $19.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.63 Typical High $13.18 | Facility | 56 · Pre-op care only | $3.09 | $3.63 | $13.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $45.71 Typical High $58.88 | Professional | 52 · Reduced service | $14.13 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $18.62 Typical High $23.44 | Professional | 53 · Discontinued | $5.75 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $69.18 Typical High $87.10 | Professional | 54 · Surgery only | $21.38 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $13.80 Typical High $17.78 | Professional | 55 · Aftercare only | $4.27 | $13.80 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $9.12 Typical High $11.75 | Professional | 56 · Pre-op care only | $2.82 | $9.12 | $11.75 |
Where California sits
The same service costs 5.4 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· 22nd of 51
$107
WI $209HI $38.90
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.