How much rates vary
Facilitymedian $2,291 · 10th to 90th $398 to $8,318Professionalmedian $129 · 10th to 90th $83 to $363
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 $645.65 Median $5,888.44 Typical High $15,848.93 | Facility | None | $645.65 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $158.49 | Professional | None | $81.28 | $120.23 | $158.49 |
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 $83.18 Median $125.89 Typical High $208.93 | Professional | None | $83.18 | $125.89 | $208.93 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $645.65 Typical High $6,456.54 | Facility | None | $100.00 | $645.65 | $6,456.54 |
Blue Shield Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $173.78 | Professional | None | $72.44 | $112.20 | $173.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $275.42 | Professional | None | $107.15 | $204.17 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,187.76 Typical High $4,365.16 | Facility | None | $575.44 | $2,187.76 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $147.91 Typical High $234.42 | Professional | None | $93.33 | $147.91 | $234.42 |
Contra Costa Health Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $275.42 | Professional | None | $95.50 | $134.90 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $194.98 Typical High $309.03 | Professional | None | $87.10 | $194.98 | $309.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,258.93 | $1,659.59 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $245.47 | Professional | None | $147.91 | $147.91 | $245.47 |
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 $213.80 Median $2,041.74 Typical High $4,786.30 | Facility | None | $213.80 | $2,041.74 | $4,786.30 |
Providence Setting Professional Modifier None Typical Low $93.33 Median $147.91 Typical High $229.09 | Professional | None | $93.33 | $147.91 | $229.09 |
Sutter Health Plus Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $537.03 | Professional | None | $295.12 | $295.12 | $537.03 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,090.30 | $10,964.78 |
United Setting Professional Modifier None Typical Low $74.13 Median $134.90 Typical High $251.19 | Professional | None | $74.13 | $134.90 | $251.19 |
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 $42.66 Median $48.98 Typical High $79.43 | Facility | 52 · Reduced service | $42.66 | $48.98 | $79.43 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.38 Median $19.50 Typical High $31.62 | Facility | 53 · Discontinued | $17.38 | $19.50 | $31.62 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $64.57 Median $72.44 Typical High $120.23 | Facility | 54 · Surgery only | $64.57 | $72.44 | $120.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.88 Median $14.45 Typical High $23.99 | Facility | 55 · Aftercare only | $12.88 | $14.45 | $23.99 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.77 Typical High $15.85 | Facility | 56 · Pre-op care only | $8.71 | $9.77 | $15.85 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $60.26 Typical High $79.43 | Professional | 52 · Reduced service | $41.69 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $23.99 Typical High $31.62 | Professional | 53 · Discontinued | $16.60 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $89.13 Typical High $120.23 | Professional | 54 · Surgery only | $63.10 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $17.78 Typical High $23.99 | Professional | 55 · Aftercare only | $12.59 | $17.78 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $12.02 Typical High $15.85 | Professional | 56 · Pre-op care only | $8.32 | $12.02 | $15.85 |
Where California sits
The same service costs 3.6 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· 48th of 51
$132
AK $407DC $112
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.