How much rates vary
Facilitymedian $2,291 · 10th to 90th $120 to $9,333Professionalmedian $110 · 10th to 90th $65 to $170
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 $154.88 Median $3,981.07 Typical High $14,454.40 | Facility | None | $154.88 | $3,981.07 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $109.65 Typical High $162.18 | Professional | None | $58.88 | $109.65 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $18.62 Median $81.28 Typical High $234.42 | Professional | None | $18.62 | $81.28 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,772.37 | Facility | None | $2,137.96 | $4,786.30 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $151.36 | Professional | None | $93.33 | $112.20 | $151.36 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $977.24 Typical High $1,949.84 | Facility | None | $69.18 | $977.24 | $1,949.84 |
Blue Shield Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $165.96 | Professional | None | $79.43 | $114.82 | $165.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $45.71 Median $107.15 Typical High $131.83 | Professional | None | $45.71 | $107.15 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $141.25 | Professional | None | $75.86 | $102.33 | $141.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $40.74 Median $100.00 Typical High $128.82 | Professional | None | $40.74 | $100.00 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $91.20 Typical High $147.91 | Professional | None | $38.02 | $91.20 | $147.91 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $123.03 | Professional | None | $74.13 | $74.13 | $123.03 |
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 $107.15 Median $1,096.48 Typical High $6,165.95 | Facility | None | $107.15 | $1,096.48 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $141.25 | Professional | None | $75.86 | $102.33 | $141.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $275.42 | Professional | None | $141.25 | $141.25 | $275.42 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,918.31 | Facility | None | $616.60 | $1,621.81 | $6,918.31 |
United Setting Professional Modifier None Typical Low $36.31 Median $85.11 Typical High $151.36 | Professional | None | $36.31 | $85.11 | $151.36 |
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 $43.65 Median $66.07 Typical High $288.40 | Facility | 52 · Reduced service | $43.65 | $66.07 | $288.40 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.38 Median $26.92 Typical High $117.49 | Facility | 53 · Discontinued | $17.38 | $26.92 | $117.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $66.07 Median $100.00 Typical High $436.52 | Facility | 54 · Surgery only | $66.07 | $100.00 | $436.52 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.18 Median $19.95 Typical High $87.10 | Facility | 55 · Aftercare only | $13.18 | $19.95 | $87.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $13.18 Typical High $57.54 | Facility | 56 · Pre-op care only | $8.71 | $13.18 | $57.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $45.71 Typical High $61.66 | Professional | 52 · Reduced service | $39.81 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $18.20 Typical High $24.55 | Professional | 53 · Discontinued | $16.22 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $67.61 Typical High $93.33 | Professional | 54 · Surgery only | $60.26 | $67.61 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.49 Typical High $18.62 | Professional | 55 · Aftercare only | $12.02 | $13.49 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $9.12 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.13 | $9.12 | $12.30 |
Where California sits
The same service costs 2.5 times more in North Carolina 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· 15th of 51
$110
NC $174FL $70.79
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.