How much rates vary
Facilitymedian $490 · 10th to 90th $100 to $5,623Professionalmedian $112 · 10th to 90th $59 to $331
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 $354.81 Median $5,128.61 Typical High $15,135.61 | Facility | None | $354.81 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $112.20 Typical High $177.83 | Professional | None | $66.07 | $112.20 | $177.83 |
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 $69.18 Median $114.82 Typical High $275.42 | Professional | None | $69.18 | $114.82 | $275.42 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $416.87 Typical High $1,412.54 | Facility | None | $100.00 | $416.87 | $1,412.54 |
Blue Shield Setting Professional Modifier None Typical Low $52.48 Median $102.33 Typical High $234.42 | Professional | None | $52.48 | $102.33 | $234.42 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $48.98 Median $83.18 Typical High $144.54 | Professional | None | $48.98 | $83.18 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $144.54 Typical High $758.58 | Facility | None | $91.20 | $144.54 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $93.33 Typical High $181.97 | Professional | None | $51.29 | $93.33 | $181.97 |
Contra Costa Health Setting Professional Modifier None Typical Low $53.70 Median $70.79 Typical High $141.25 | Professional | None | $53.70 | $70.79 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $109.65 Typical High $229.09 | Professional | None | $48.98 | $109.65 | $229.09 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | None | $724.44 | $724.44 | $870.96 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $134.90 | Professional | None | $81.28 | $81.28 | $134.90 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $169.82 Typical High $2,570.40 | Facility | None | $87.10 | $169.82 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $51.29 Median $93.33 Typical High $181.97 | Professional | None | $51.29 | $93.33 | $181.97 |
Sutter Health Plus Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $316.23 | Professional | None | $169.82 | $169.82 | $316.23 |
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 $43.65 Median $93.33 Typical High $218.78 | Professional | None | $43.65 | $93.33 | $218.78 |
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 $37.15 Median $38.90 Typical High $67.61 | Facility | 52 · Reduced service | $37.15 | $38.90 | $67.61 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $15.49 Typical High $27.54 | Facility | 53 · Discontinued | $14.79 | $15.49 | $27.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $54.95 Median $58.88 Typical High $102.33 | Facility | 54 · Surgery only | $54.95 | $58.88 | $102.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.96 Median $11.75 Typical High $20.42 | Facility | 55 · Aftercare only | $10.96 | $11.75 | $20.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.76 Typical High $13.80 | Facility | 56 · Pre-op care only | $7.41 | $7.76 | $13.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $46.77 Typical High $63.10 | Professional | 52 · Reduced service | $34.67 | $46.77 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $18.62 Typical High $25.12 | Professional | 53 · Discontinued | $13.80 | $18.62 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $69.18 Typical High $93.33 | Professional | 54 · Surgery only | $52.48 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $13.80 Typical High $18.62 | Professional | 55 · Aftercare only | $10.47 | $13.80 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $9.33 Typical High $12.59 | Professional | 56 · Pre-op care only | $6.92 | $9.33 | $12.59 |
Where California sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 24th of 51
$115
WI $257KY $91.20
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.