How much rates vary
Facilitymedian $4,074 · 10th to 90th $457 to $12,589Professionalmedian $129 · 10th to 90th $95 to $832
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 $107.15 Median $117.49 Typical High $131.83 | Professional | None | $107.15 | $117.49 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,128.61 Typical High $10,471.29 | Facility | None | $2,137.96 | $5,128.61 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $190.55 | Professional | None | $107.15 | $128.82 | $190.55 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $758.58 Typical High $14,125.38 | Facility | None | $100.00 | $758.58 | $14,125.38 |
Blue Shield Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $154.88 | Professional | None | $89.13 | $128.82 | $154.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $138.04 | Professional | None | $109.65 | $131.83 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $6,309.57 Typical High $10,964.78 | Facility | None | $537.03 | $6,309.57 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $181.97 | Professional | None | $95.50 | $123.03 | $181.97 |
Contra Costa Health Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $131.83 | Professional | None | $77.62 | $120.23 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $251.19 | Professional | None | $102.33 | $114.82 | $251.19 |
Lucent Health Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $954.99 | Professional | None | $831.76 | $954.99 | $954.99 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
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 $346.74 Median $5,495.41 Typical High $10,000.00 | Facility | None | $346.74 | $5,495.41 | $10,000.00 |
Providence Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $177.83 | Professional | None | $95.50 | $120.23 | $177.83 |
Sutter Health Plus Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,073.80 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,073.80 | $14,454.40 |
United Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $181.97 | Professional | None | $91.20 | $120.23 | $181.97 |
5 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 $53.70 Median $57.54 Typical High $66.07 | Professional | 52 · Reduced service | $53.70 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $23.44 Typical High $26.30 | Professional | 53 · Discontinued | $21.38 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $87.10 Typical High $97.72 | Professional | 54 · Surgery only | $81.28 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.38 Typical High $19.50 | Professional | 55 · Aftercare only | $16.22 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.75 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.72 | $11.75 | $13.18 |
Where California sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 34th of 51
$129
AK $468UT $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.