How much rates vary
Facilitymedian $977 · 10th to 90th $427 to $7,079Professionalmedian $389 · 10th to 90th $166 to $1,820
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 $645.65 Median $5,888.44 Typical High $15,848.93 | Facility | None | $645.65 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $389.05 Typical High $501.19 | Professional | None | $165.96 | $389.05 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $407.38 Typical High $1,023.29 | Professional | None | $165.96 | $407.38 | $1,023.29 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,548.82 Typical High $6,165.95 | Facility | None | $100.00 | $1,548.82 | $6,165.95 |
Blue Shield Setting Professional Modifier None Typical Low $128.82 Median $288.40 Typical High $660.69 | Professional | None | $128.82 | $288.40 | $660.69 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $524.81 | Professional | None | $151.36 | $213.80 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $588.84 Typical High $1,445.44 | Facility | None | $416.87 | $588.84 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $354.81 Typical High $707.95 | Professional | None | $165.96 | $354.81 | $707.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $512.86 | Professional | None | $151.36 | $181.97 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $389.05 Typical High $891.25 | Professional | None | $151.36 | $389.05 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,162.28 | Professional | None | $2,951.21 | $2,951.21 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $524.81 | Professional | None | $316.23 | $316.23 | $524.81 |
Providence Setting Facility Modifier None Typical Low $363.08 Median $602.56 Typical High $3,311.31 | Facility | None | $363.08 | $602.56 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $354.81 Typical High $707.95 | Professional | None | $165.96 | $354.81 | $707.95 |
Sutter Health Plus Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,318.26 | Professional | None | $537.03 | $537.03 | $1,318.26 |
United Setting Facility Modifier None Typical Low $446.68 Median $812.83 Typical High $3,019.95 | Facility | None | $446.68 | $812.83 | $3,019.95 |
United Setting Professional Modifier None Typical Low $138.04 Median $354.81 Typical High $794.33 | Professional | None | $138.04 | $354.81 | $794.33 |
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 $87.10 Median $91.20 Typical High $251.19 | Facility | 52 · Reduced service | $87.10 | $91.20 | $251.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $34.67 Median $36.31 Typical High $100.00 | Facility | 53 · Discontinued | $34.67 | $36.31 | $100.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $131.83 Median $138.04 Typical High $371.54 | Facility | 54 · Surgery only | $131.83 | $138.04 | $371.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.30 Median $27.54 Typical High $74.13 | Facility | 55 · Aftercare only | $26.30 | $27.54 | $74.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $18.20 Typical High $50.12 | Facility | 56 · Pre-op care only | $17.38 | $18.20 | $50.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $169.82 Typical High $229.09 | Professional | 52 · Reduced service | $83.18 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $67.61 Typical High $91.20 | Professional | 53 · Discontinued | $33.11 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $251.19 Typical High $338.84 | Professional | 54 · Surgery only | $125.89 | $251.19 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $51.29 Typical High $67.61 | Professional | 55 · Aftercare only | $25.12 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $33.88 Typical High $45.71 | Professional | 56 · Pre-op care only | $16.60 | $33.88 | $45.71 |
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· 20th of 51
$427
WI $871KY $309
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.