How much rates vary
Facilitymedian $1,259 · 10th to 90th $537 to $6,026Professionalmedian $182 · 10th to 90th $123 to $1,202
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 $123.03 Median $147.91 Typical High $512.86 | Professional | None | $123.03 | $147.91 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $2,137.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $436.52 | Professional | None | $165.96 | $165.96 | $436.52 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,047.13 Typical High $4,897.79 | Facility | None | $100.00 | $1,047.13 | $4,897.79 |
Blue Shield Setting Professional Modifier None Typical Low $107.15 Median $288.40 Typical High $467.74 | Professional | None | $107.15 | $288.40 | $467.74 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $144.54 Median $295.12 Typical High $616.60 | Professional | None | $144.54 | $295.12 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,380.38 Typical High $2,754.23 | Facility | None | $426.58 | $1,380.38 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $501.19 | Professional | None | $131.83 | $158.49 | $501.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $602.56 | Professional | None | $131.83 | $177.83 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $380.19 Typical High $660.69 | Professional | None | $120.23 | $380.19 | $660.69 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $3,630.78 Typical High $3,630.78 | Professional | None | $2,691.53 | $3,630.78 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $524.81 | Professional | None | $316.23 | $316.23 | $524.81 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $1,348.96 Typical High $3,467.37 | Facility | None | $338.84 | $1,348.96 | $3,467.37 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $489.78 | Professional | None | $131.83 | $154.88 | $489.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $1,202.26 | Professional | None | $426.58 | $426.58 | $1,202.26 |
United Setting Facility Modifier None Typical Low $691.83 Median $758.58 Typical High $4,466.84 | Facility | None | $691.83 | $758.58 | $4,466.84 |
United Setting Professional Modifier None Typical Low $104.71 Median $234.42 Typical High $549.54 | Professional | None | $104.71 | $234.42 | $549.54 |
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 $63.10 Median $67.61 Typical High $173.78 | Professional | 52 · Reduced service | $63.10 | $67.61 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $26.92 Typical High $69.18 | Professional | 53 · Discontinued | $25.12 | $26.92 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $100.00 Typical High $263.03 | Professional | 54 · Surgery only | $95.50 | $100.00 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.95 Typical High $52.48 | Professional | 55 · Aftercare only | $19.05 | $19.95 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.49 Typical High $34.67 | Professional | 56 · Pre-op care only | $12.59 | $13.49 | $34.67 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 59 · Distinct service | $109.65 | $109.65 | $109.65 |
Where California sits
The same service costs 5.7 times more in Colorado 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
CO $4,090MT $722
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.