How much rates vary
Facilitymedian $3,548 · 10th to 90th $302 to $10,965Professionalmedian $107 · 10th to 90th $69 to $661
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 $69.18 Median $95.50 Typical High $117.49 | Professional | None | $69.18 | $95.50 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $10,000.00 | Facility | None | $2,137.96 | $4,786.30 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $208.93 | Professional | None | $79.43 | $112.20 | $208.93 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $154.88 | Professional | None | $53.70 | $77.62 | $154.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $79.43 Median $165.96 Typical High $478.63 | Professional | None | $79.43 | $165.96 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $102.33 Typical High $190.55 | Professional | None | $69.18 | $102.33 | $190.55 |
Contra Costa Health Setting Professional Modifier None Typical Low $72.44 Median $147.91 Typical High $269.15 | Professional | None | $72.44 | $147.91 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $123.03 Typical High $213.80 | Professional | None | $64.57 | $123.03 | $213.80 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,715.35 | Professional | None | $2,238.72 | $2,238.72 | $3,715.35 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $100.00 Typical High $165.96 | Professional | None | $33.11 | $100.00 | $165.96 |
Providence Setting Facility Modifier None Typical Low $75.86 Median $138.04 Typical High $398.11 | Facility | None | $75.86 | $138.04 | $398.11 |
Providence Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $190.55 | Professional | None | $69.18 | $100.00 | $190.55 |
Sutter Health Plus Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $363.08 | Professional | None | $229.09 | $229.09 | $363.08 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $7,244.36 | Facility | None | $602.56 | $1,698.24 | $7,244.36 |
United Setting Professional Modifier None Typical Low $60.26 Median $104.71 Typical High $213.80 | Professional | None | $60.26 | $104.71 | $213.80 |
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 $38.02 Median $39.81 Typical High $58.88 | Facility | 52 · Reduced service | $38.02 | $39.81 | $58.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.14 Median $15.85 Typical High $23.44 | Facility | 53 · Discontinued | $15.14 | $15.85 | $23.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $56.23 Median $60.26 Typical High $89.13 | Facility | 54 · Surgery only | $56.23 | $60.26 | $89.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $12.02 Typical High $17.78 | Facility | 55 · Aftercare only | $11.22 | $12.02 | $17.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.94 Typical High $11.75 | Facility | 56 · Pre-op care only | $7.59 | $7.94 | $11.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $45.71 Typical High $58.88 | Professional | 52 · Reduced service | $35.48 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $18.62 Typical High $23.44 | Professional | 53 · Discontinued | $14.45 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $69.18 Typical High $89.13 | Professional | 54 · Surgery only | $53.70 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.80 Typical High $17.78 | Professional | 55 · Aftercare only | $10.72 | $13.80 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $9.12 Typical High $11.75 | Professional | 56 · Pre-op care only | $7.08 | $9.12 | $11.75 |
Where California sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 41st of 51
$107
AK $282FL $87.10
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.