How much rates vary
Facilitymedian $1,995 · 10th to 90th $398 to $6,607Professionalmedian $166 · 10th to 90th $74 to $427
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 $77.62 Median $165.96 Typical High $229.09 | Professional | None | $77.62 | $165.96 | $229.09 |
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 $85.11 Median $186.21 Typical High $213.80 | Professional | None | $85.11 | $186.21 | $213.80 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $758.58 Typical High $4,897.79 | Facility | None | $100.00 | $758.58 | $4,897.79 |
Blue Shield Setting Professional Modifier None Typical Low $69.18 Median $165.96 Typical High $263.03 | Professional | None | $69.18 | $165.96 | $263.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $331.13 | Professional | None | $100.00 | $162.18 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $2,137.96 Typical High $3,548.13 | Facility | None | $426.58 | $2,137.96 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $128.82 Typical High $257.04 | Professional | None | $52.48 | $128.82 | $257.04 |
Contra Costa Health Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $323.59 | Professional | None | $89.13 | $117.49 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $218.78 Typical High $371.54 | Professional | None | $81.28 | $218.78 | $371.54 |
Lucent Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,995.26 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $281.84 | Professional | None | $169.82 | $169.82 | $281.84 |
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 $245.47 Median $1,905.46 Typical High $3,715.35 | Facility | None | $245.47 | $1,905.46 | $3,715.35 |
Providence Setting Professional Modifier None Typical Low $52.48 Median $123.03 Typical High $245.47 | Professional | None | $52.48 | $123.03 | $245.47 |
Sutter Health Plus Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $602.56 | Professional | None | $269.15 | $269.15 | $602.56 |
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 $67.61 Median $151.36 Typical High $302.00 | Professional | None | $67.61 | $151.36 | $302.00 |
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 $38.90 Median $43.65 Typical High $114.82 | Facility | 52 · Reduced service | $38.90 | $43.65 | $114.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.49 Median $17.78 Typical High $45.71 | Facility | 53 · Discontinued | $15.49 | $17.78 | $45.71 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $58.88 Median $66.07 Typical High $169.82 | Facility | 54 · Surgery only | $58.88 | $66.07 | $169.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.75 Median $13.18 Typical High $33.88 | Facility | 55 · Aftercare only | $11.75 | $13.18 | $33.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.91 Typical High $22.91 | Facility | 56 · Pre-op care only | $7.76 | $8.91 | $22.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $74.13 Typical High $114.82 | Professional | 52 · Reduced service | $37.15 | $74.13 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $29.51 Typical High $45.71 | Professional | 53 · Discontinued | $14.79 | $29.51 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $109.65 Typical High $169.82 | Professional | 54 · Surgery only | $56.23 | $109.65 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $22.39 Typical High $33.88 | Professional | 55 · Aftercare only | $11.22 | $22.39 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $14.79 Typical High $22.91 | Professional | 56 · Pre-op care only | $7.41 | $14.79 | $22.91 |
Where California sits
The same service costs 4.5 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
$170
AK $437DC $97.72
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.