How much rates vary
Facilitymedian $1,660 · 10th to 90th $447 to $6,918Professionalmedian $178 · 10th to 90th $87 to $468
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 $89.13 Median $173.78 Typical High $239.88 | Professional | None | $89.13 | $173.78 | $239.88 |
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 $100.00 Median $199.53 Typical High $229.09 | Professional | None | $100.00 | $199.53 | $229.09 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $758.58 Typical High $5,623.41 | Facility | None | $100.00 | $758.58 | $5,623.41 |
Blue Shield Setting Professional Modifier None Typical Low $79.43 Median $165.96 Typical High $269.15 | Professional | None | $79.43 | $165.96 | $269.15 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $338.84 | Professional | None | $97.72 | $117.49 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $2,137.96 Typical High $4,365.16 | Facility | None | $426.58 | $2,137.96 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $158.49 Typical High $263.03 | Professional | None | $58.88 | $158.49 | $263.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $331.13 | Professional | None | $77.62 | $114.82 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $229.09 Typical High $380.19 | Professional | None | $95.50 | $229.09 | $380.19 |
Lucent Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,513.56 | $2,089.30 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $295.12 | Professional | None | $177.83 | $177.83 | $295.12 |
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 $263.03 Median $1,905.46 Typical High $4,570.88 | Facility | None | $263.03 | $1,905.46 | $4,570.88 |
Providence Setting Professional Modifier None Typical Low $58.88 Median $158.49 Typical High $257.04 | Professional | None | $58.88 | $158.49 | $257.04 |
Sutter Health Plus Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $616.60 | Professional | None | $316.23 | $316.23 | $616.60 |
United Setting Facility Modifier None Typical Low $575.44 Median $933.25 Typical High $7,585.78 | Facility | None | $575.44 | $933.25 | $7,585.78 |
United Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $309.03 | Professional | None | $79.43 | $162.18 | $309.03 |
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 $45.71 Median $51.29 Typical High $120.23 | Facility | 52 · Reduced service | $45.71 | $51.29 | $120.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $20.42 Typical High $47.86 | Facility | 53 · Discontinued | $18.20 | $20.42 | $47.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $69.18 Median $77.62 Typical High $177.83 | Facility | 54 · Surgery only | $69.18 | $77.62 | $177.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.80 Median $15.49 Typical High $35.48 | Facility | 55 · Aftercare only | $13.80 | $15.49 | $35.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.23 Typical High $23.99 | Facility | 56 · Pre-op care only | $9.12 | $10.23 | $23.99 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $75.86 Typical High $120.23 | Professional | 52 · Reduced service | $43.65 | $75.86 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $30.90 Typical High $47.86 | Professional | 53 · Discontinued | $17.38 | $30.90 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $114.82 Typical High $177.83 | Professional | 54 · Surgery only | $64.57 | $114.82 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $22.91 Typical High $35.48 | Professional | 55 · Aftercare only | $13.18 | $22.91 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $15.14 Typical High $23.99 | Professional | 56 · Pre-op care only | $8.71 | $15.14 | $23.99 |
Where California sits
The same service costs 4.0 times more in Alaska 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· 36th of 51
$182
AK $468DC $117
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.