How much rates vary
Facilitymedian $891 · 10th to 90th $148 to $6,761Professionalmedian $302 · 10th to 90th $79 to $724
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 $478.63 Median $5,128.61 Typical High $15,135.61 | Facility | None | $478.63 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $295.12 Typical High $426.58 | Professional | None | $79.43 | $295.12 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,897.79 Typical High $10,000.00 | Facility | None | $2,511.89 | $4,897.79 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $302.00 Typical High $602.56 | Professional | None | $128.82 | $302.00 | $602.56 |
Blue Shield Setting Facility Modifier None Typical Low $74.13 Median $2,691.53 Typical High $6,309.57 | Facility | None | $74.13 | $2,691.53 | $6,309.57 |
Blue Shield Setting Professional Modifier None Typical Low $64.57 Median $251.19 Typical High $398.11 | Professional | None | $64.57 | $251.19 | $398.11 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $104.71 Median $416.87 Typical High $562.34 | Professional | None | $104.71 | $416.87 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $295.12 Typical High $1,348.96 | Facility | None | $186.21 | $295.12 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $281.84 Typical High $457.09 | Professional | None | $83.18 | $281.84 | $457.09 |
Contra Costa Health Setting Professional Modifier None Typical Low $93.33 Median $302.00 Typical High $549.54 | Professional | None | $93.33 | $302.00 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $363.08 Typical High $602.56 | Professional | None | $85.11 | $363.08 | $602.56 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,290.87 | $3,235.94 | $3,235.94 |
Providence Setting Facility Modifier None Typical Low $173.78 Median $436.52 Typical High $2,754.23 | Facility | None | $173.78 | $436.52 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $83.18 Median $257.04 Typical High $446.68 | Professional | None | $83.18 | $257.04 | $446.68 |
Sutter Health Plus Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $1,148.15 | Professional | None | $275.42 | $275.42 | $1,148.15 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $67.61 Median $281.84 Typical High $512.86 | Professional | None | $67.61 | $281.84 | $512.86 |
9 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 $39.81 Median $43.65 Typical High $194.98 | Facility | 52 · Reduced service | $39.81 | $43.65 | $194.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.85 Median $17.78 Typical High $79.43 | Facility | 53 · Discontinued | $15.85 | $17.78 | $79.43 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.75 Median $13.18 Typical High $58.88 | Facility | 55 · Aftercare only | $11.75 | $13.18 | $58.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.91 Typical High $39.81 | Facility | 56 · Pre-op care only | $7.94 | $8.91 | $39.81 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $138.04 Typical High $194.98 | Professional | 52 · Reduced service | $39.81 | $138.04 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $54.95 Typical High $77.62 | Professional | 53 · Discontinued | $15.85 | $54.95 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $208.93 Typical High $288.40 | Professional | 54 · Surgery only | $58.88 | $208.93 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $41.69 Typical High $58.88 | Professional | 55 · Aftercare only | $11.75 | $41.69 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $27.54 Typical High $38.90 | Professional | 56 · Pre-op care only | $7.94 | $27.54 | $38.90 |
Where California sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 25th of 51
$302
WI $479DC $100
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.