How much rates vary
Facilitymedian $417 · 10th to 90th $74 to $5,754Professionalmedian $85 · 10th to 90th $39 to $191
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 $173.78 Median $5,128.61 Typical High $15,135.61 | Facility | None | $173.78 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $85.11 Typical High $131.83 | Professional | None | $38.90 | $85.11 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $446.68 | Professional | None | $70.79 | $83.18 | $446.68 |
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 $45.71 Median $89.13 Typical High $213.80 | Professional | None | $45.71 | $89.13 | $213.80 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $1,479.11 | Facility | None | $97.72 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $37.15 Median $77.62 Typical High $169.82 | Professional | None | $37.15 | $77.62 | $169.82 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $31.62 Median $100.00 Typical High $141.25 | Professional | None | $31.62 | $100.00 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $91.20 Typical High $190.55 | Facility | None | $53.70 | $91.20 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $79.43 Typical High $144.54 | Professional | None | $41.69 | $79.43 | $144.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $28.18 Median $79.43 Typical High $117.49 | Professional | None | $28.18 | $79.43 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.30 Median $79.43 Typical High $181.97 | Professional | None | $26.30 | $79.43 | $181.97 |
Lucent Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $107.15 | Professional | None | $63.10 | $63.10 | $107.15 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $91.20 Typical High $186.21 | Facility | None | $50.12 | $91.20 | $186.21 |
Providence Setting Professional Modifier None Typical Low $41.69 Median $79.43 Typical High $151.36 | Professional | None | $41.69 | $79.43 | $151.36 |
Sutter Health Plus Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $251.19 | Professional | None | $100.00 | $100.00 | $251.19 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $28.18 Median $69.18 Typical High $158.49 | Professional | None | $28.18 | $69.18 | $158.49 |
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 $23.44 Median $24.55 Typical High $52.48 | Facility | 52 · Reduced service | $23.44 | $24.55 | $52.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.33 Median $9.77 Typical High $20.89 | Facility | 53 · Discontinued | $9.33 | $9.77 | $20.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $35.48 Median $36.31 Typical High $77.62 | Facility | 54 · Surgery only | $35.48 | $36.31 | $77.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.08 Median $7.24 Typical High $15.85 | Facility | 55 · Aftercare only | $7.08 | $7.24 | $15.85 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.90 Typical High $10.47 | Facility | 56 · Pre-op care only | $4.68 | $4.90 | $10.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $35.48 Typical High $47.86 | Professional | 52 · Reduced service | $22.39 | $35.48 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $14.13 Typical High $19.05 | Professional | 53 · Discontinued | $9.12 | $14.13 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $53.70 Typical High $72.44 | Professional | 54 · Surgery only | $33.88 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $10.72 Typical High $14.45 | Professional | 55 · Aftercare only | $6.76 | $10.72 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $7.08 Typical High $9.55 | Professional | 56 · Pre-op care only | $4.47 | $7.08 | $9.55 |
Where California sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 21st of 51
$89.13
WI $186NE $60.26
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.