How much rates vary
Facilitymedian $1,096 · 10th to 90th $363 to $6,457Professionalmedian $148 · 10th to 90th $71 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 $74.13 Median $144.54 Typical High $275.42 | Professional | None | $74.13 | $144.54 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
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 $70.79 Median $147.91 Typical High $194.98 | Professional | None | $70.79 | $147.91 | $194.98 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $645.65 Typical High $4,570.88 | Facility | None | $100.00 | $645.65 | $4,570.88 |
Blue Shield Setting Professional Modifier None Typical Low $63.10 Median $131.83 Typical High $208.93 | Professional | None | $63.10 | $131.83 | $208.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $363.08 | Professional | None | $95.50 | $125.89 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $831.76 Typical High $1,698.24 | Facility | None | $426.58 | $831.76 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $154.88 Typical High $275.42 | Professional | None | $81.28 | $154.88 | $275.42 |
Contra Costa Health Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $354.81 | Professional | None | $75.86 | $93.33 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $234.42 Typical High $389.05 | Professional | None | $77.62 | $234.42 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,548.82 | $2,089.30 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $309.03 | Professional | None | $186.21 | $186.21 | $309.03 |
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 $234.42 Median $794.33 Typical High $2,454.71 | Facility | None | $234.42 | $794.33 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $81.28 Median $154.88 Typical High $251.19 | Professional | None | $81.28 | $154.88 | $251.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $676.08 | Professional | None | $263.03 | $263.03 | $676.08 |
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 $64.57 Median $158.49 Typical High $323.59 | Professional | None | $64.57 | $158.49 | $323.59 |
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 $37.15 Median $42.66 Typical High $100.00 | Facility | 52 · Reduced service | $37.15 | $42.66 | $100.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $16.98 Typical High $39.81 | Facility | 53 · Discontinued | $14.79 | $16.98 | $39.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $56.23 Median $63.10 Typical High $147.91 | Facility | 54 · Surgery only | $56.23 | $63.10 | $147.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $12.59 Typical High $29.51 | Facility | 55 · Aftercare only | $11.22 | $12.59 | $29.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.51 Typical High $19.95 | Facility | 56 · Pre-op care only | $7.41 | $8.51 | $19.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $72.44 Typical High $100.00 | Professional | 52 · Reduced service | $37.15 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $28.84 Typical High $39.81 | Professional | 53 · Discontinued | $14.79 | $28.84 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $109.65 Typical High $147.91 | Professional | 54 · Surgery only | $56.23 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $21.88 Typical High $29.51 | Professional | 55 · Aftercare only | $11.22 | $21.88 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $14.45 Typical High $19.95 | Professional | 56 · Pre-op care only | $7.41 | $14.45 | $19.95 |
Where California sits
The same service costs 4.1 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· 47th of 51
$148
AK $398DC $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.