How much rates vary
Facilitymedian $871 · 10th to 90th $78 to $6,607Professionalmedian $100 · 10th to 90th $35 to $347
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 $354.81 Median $5,128.61 Typical High $15,135.61 | Facility | None | $354.81 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $120.23 Typical High $169.82 | Professional | None | $36.31 | $120.23 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $123.03 Typical High $147.91 | Professional | None | $35.48 | $123.03 | $147.91 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $1,584.89 | Facility | None | $97.72 | $416.87 | $1,584.89 |
Blue Shield Setting Professional Modifier None Typical Low $29.51 Median $64.57 Typical High $109.65 | Professional | None | $29.51 | $64.57 | $109.65 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $50.12 Median $66.07 Typical High $257.04 | Professional | None | $50.12 | $66.07 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $676.08 | Facility | None | $50.12 | $61.66 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $97.72 Typical High $208.93 | Professional | None | $38.02 | $97.72 | $208.93 |
Contra Costa Health Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $251.19 | Professional | None | $39.81 | $50.12 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $162.18 Typical High $275.42 | Professional | None | $39.81 | $162.18 | $275.42 |
Lucent Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,479.11 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $218.78 | Professional | None | $131.83 | $131.83 | $218.78 |
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 $46.77 Median $66.07 Typical High $676.08 | Facility | None | $46.77 | $66.07 | $676.08 |
Providence Setting Professional Modifier None Typical Low $38.02 Median $97.72 Typical High $186.21 | Professional | None | $38.02 | $97.72 | $186.21 |
Sutter Health Plus Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $524.81 | Professional | None | $131.83 | $131.83 | $524.81 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,230.27 Typical High $4,677.35 | Facility | None | $398.11 | $1,230.27 | $4,677.35 |
United Setting Professional Modifier None Typical Low $32.36 Median $120.23 Typical High $229.09 | Professional | None | $32.36 | $120.23 | $229.09 |
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 $18.20 Median $21.38 Typical High $85.11 | Facility | 52 · Reduced service | $18.20 | $21.38 | $85.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.41 Median $8.51 Typical High $33.88 | Facility | 53 · Discontinued | $7.41 | $8.51 | $33.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $27.54 Median $31.62 Typical High $128.82 | Facility | 54 · Surgery only | $27.54 | $31.62 | $128.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.50 Median $6.31 Typical High $25.70 | Facility | 55 · Aftercare only | $5.50 | $6.31 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.27 Typical High $16.98 | Facility | 56 · Pre-op care only | $3.63 | $4.27 | $16.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $57.54 Typical High $85.11 | Professional | 52 · Reduced service | $17.78 | $57.54 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $23.44 Typical High $33.88 | Professional | 53 · Discontinued | $7.08 | $23.44 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $89.13 Typical High $128.82 | Professional | 54 · Surgery only | $26.92 | $89.13 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $17.78 Typical High $25.70 | Professional | 55 · Aftercare only | $5.37 | $17.78 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $11.75 Typical High $16.98 | Professional | 56 · Pre-op care only | $3.55 | $11.75 | $16.98 |
Where California sits
The same service costs 4.6 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· 39th of 51
$100
WI $240DC $52.48
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.