How much rates vary
Facilitymedian $676 · 10th to 90th $76 to $6,457Professionalmedian $72 · 10th to 90th $35 to $214
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 $100.00 Median $5,011.87 Typical High $15,135.61 | Facility | None | $100.00 | $5,011.87 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $72.44 Typical High $158.49 | Professional | None | $36.31 | $72.44 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $154.88 | Professional | None | $120.23 | $125.89 | $154.88 |
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 $33.88 Median $72.44 Typical High $95.50 | Professional | None | $33.88 | $72.44 | $95.50 |
Blue Shield Setting Facility Modifier None Typical Low $89.13 Median $416.87 Typical High $1,479.11 | Facility | None | $89.13 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $31.62 Median $66.07 Typical High $107.15 | Professional | None | $31.62 | $66.07 | $107.15 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $31.62 Median $54.95 Typical High $194.98 | Professional | None | $31.62 | $54.95 | $194.98 |
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 $34.67 Median $74.13 Typical High $141.25 | Professional | None | $34.67 | $74.13 | $141.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $21.88 Median $53.70 Typical High $190.55 | Professional | None | $21.88 | $53.70 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $125.89 Typical High $213.80 | Professional | None | $42.66 | $125.89 | $213.80 |
Lucent Health Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,122.02 | Professional | None | $812.83 | $1,122.02 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $162.18 | Professional | None | $97.72 | $97.72 | $162.18 |
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 $48.98 Median $66.07 Typical High $676.08 | Facility | None | $48.98 | $66.07 | $676.08 |
Providence Setting Professional Modifier None Typical Low $34.67 Median $74.13 Typical High $131.83 | Professional | None | $34.67 | $74.13 | $131.83 |
Sutter Health Plus Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $346.74 | Professional | None | $131.83 | $131.83 | $346.74 |
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 $33.11 Median $79.43 Typical High $173.78 | Professional | None | $33.11 | $79.43 | $173.78 |
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 $20.89 Typical High $48.98 | Facility | 52 · Reduced service | $18.20 | $20.89 | $48.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.24 Median $8.51 Typical High $19.95 | Facility | 53 · Discontinued | $7.24 | $8.51 | $19.95 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $27.54 Median $31.62 Typical High $74.13 | Facility | 54 · Surgery only | $27.54 | $31.62 | $74.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.50 Median $6.31 Typical High $14.79 | Facility | 55 · Aftercare only | $5.50 | $6.31 | $14.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.17 Typical High $10.00 | Facility | 56 · Pre-op care only | $3.63 | $4.17 | $10.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $35.48 Typical High $48.98 | Professional | 52 · Reduced service | $18.20 | $35.48 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $14.13 Typical High $19.95 | Professional | 53 · Discontinued | $7.24 | $14.13 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $53.70 Typical High $74.13 | Professional | 54 · Surgery only | $26.92 | $53.70 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $10.72 Typical High $14.79 | Professional | 55 · Aftercare only | $5.37 | $10.72 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $7.08 Typical High $10.00 | Professional | 56 · Pre-op care only | $3.63 | $7.08 | $10.00 |
Where California sits
The same service costs 3.4 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· 46th of 51
$72.44
AK $178DC $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.