How much rates vary
Facilitymedian $2,692 · 10th to 90th $174 to $46,774Professionalmedian $110 · 10th to 90th $87 to $339
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 $933.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $95.50 Typical High $107.15 | Professional | None | $91.20 | $95.50 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $165.96 Median $2,511.89 Typical High $7,943.28 | Facility | None | $165.96 | $2,511.89 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $194.98 | Professional | None | $107.15 | $109.65 | $194.98 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,606.93 | Facility | None | $67.61 | $3,090.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $134.90 | Professional | None | $77.62 | $109.65 | $134.90 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $151.36 | Professional | None | $109.65 | $109.65 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $10,000.00 | Facility | None | $660.69 | $1,258.93 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $104.71 Typical High $162.18 | Professional | None | $97.72 | $104.71 | $162.18 |
Contra Costa Health Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $109.65 | Professional | None | $87.10 | $97.72 | $109.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $208.93 | Professional | None | $85.11 | $95.50 | $208.93 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
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 $199.53 Median $151,356.12 Typical High $251,188.64 | Facility | None | $199.53 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $97.72 Median $104.71 Typical High $158.49 | Professional | None | $97.72 | $104.71 | $158.49 |
Sutter Health Plus Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $165.96 | Professional | None | $85.11 | $107.15 | $165.96 |
5 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 Professional Modifier 52 · Reduced service Typical Low $45.71 Median $47.86 Typical High $53.70 | Professional | 52 · Reduced service | $45.71 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.05 Typical High $21.38 | Professional | 53 · Discontinued | $18.20 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $72.44 Typical High $81.28 | Professional | 54 · Surgery only | $69.18 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.45 Typical High $16.22 | Professional | 55 · Aftercare only | $13.80 | $14.45 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.55 Typical High $10.72 | Professional | 56 · Pre-op care only | $9.12 | $9.55 | $10.72 |
Where California sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 45th of 51
$110
AK $427NJ $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.