How much rates vary
Facilitymedian $5,888 · 10th to 90th $490 to $14,454Professionalmedian $813 · 10th to 90th $204 to $4,365
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 $1,000.00 Median $5,888.44 Typical High $15,848.93 | Facility | None | $1,000.00 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $741.31 Typical High $977.24 | Professional | None | $190.55 | $741.31 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $5,128.61 Typical High $10,471.29 | Facility | None | $2,187.76 | $5,128.61 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $1,318.26 Typical High $2,511.89 | Professional | None | $363.08 | $1,318.26 | $2,511.89 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $4,897.79 Typical High $10,000.00 | Facility | None | $69.18 | $4,897.79 | $10,000.00 |
Blue Shield Setting Professional Modifier None Typical Low $165.96 Median $616.60 Typical High $1,122.02 | Professional | None | $165.96 | $616.60 | $1,122.02 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $218.78 Median $977.24 Typical High $1,202.26 | Professional | None | $218.78 | $977.24 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $676.08 Typical High $1,380.38 | Professional | None | $213.80 | $676.08 | $1,380.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $199.53 Median $741.31 Typical High $1,202.26 | Professional | None | $199.53 | $741.31 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $691.83 Typical High $1,412.54 | Professional | None | $181.97 | $691.83 | $1,412.54 |
Lucent Health Setting Professional Modifier None Typical Low $5,888.44 Median $7,079.46 Typical High $7,079.46 | Professional | None | $5,888.44 | $7,079.46 | $7,079.46 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $676.08 Typical High $1,122.02 | Professional | None | $33.11 | $676.08 | $1,122.02 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $6,309.57 Typical High $19,054.61 | Facility | None | $288.40 | $6,309.57 | $19,054.61 |
Providence Setting Professional Modifier None Typical Low $213.80 Median $676.08 Typical High $1,380.38 | Professional | None | $213.80 | $676.08 | $1,380.38 |
Sutter Health Plus Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $2,884.03 | Professional | None | $691.83 | $691.83 | $2,884.03 |
United Setting Facility Modifier None Typical Low $5,623.41 Median $9,772.37 Typical High $20,892.96 | Facility | None | $5,623.41 | $9,772.37 | $20,892.96 |
United Setting Professional Modifier None Typical Low $186.21 Median $691.83 Typical High $1,513.56 | Professional | None | $186.21 | $691.83 | $1,513.56 |
9 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 $102.33 Median $114.82 Typical High $501.19 | Facility | 52 · Reduced service | $102.33 | $114.82 | $501.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $40.74 Median $45.71 Typical High $199.53 | Facility | 53 · Discontinued | $40.74 | $45.71 | $199.53 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.90 Median $34.67 Typical High $151.36 | Facility | 55 · Aftercare only | $30.90 | $34.67 | $151.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.91 Typical High $100.00 | Facility | 56 · Pre-op care only | $20.42 | $22.91 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $316.23 Typical High $489.78 | Professional | 52 · Reduced service | $100.00 | $316.23 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $125.89 Typical High $194.98 | Professional | 53 · Discontinued | $39.81 | $125.89 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $478.63 Typical High $741.31 | Professional | 54 · Surgery only | $151.36 | $478.63 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $95.50 Typical High $147.91 | Professional | 55 · Aftercare only | $30.20 | $95.50 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $63.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $19.95 | $63.10 | $97.72 |
Where California sits
The same service costs 5.4 times more in Wisconsin than in Maryland. 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· 25th of 51
$813
WI $1,514MD $282
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.