How much rates vary
Facilitymedian $1,549 · 10th to 90th $603 to $7,244Professionalmedian $309 · 10th to 90th $151 to $955
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 $398.11 Median $5,754.40 Typical High $15,848.93 | Facility | None | $398.11 | $5,754.40 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $302.00 Typical High $524.81 | Professional | None | $151.36 | $302.00 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $295.12 Typical High $331.13 | Professional | None | $57.54 | $295.12 | $331.13 |
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 $158.49 Median $309.03 Typical High $831.76 | Professional | None | $158.49 | $309.03 | $831.76 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,584.89 Typical High $6,309.57 | Facility | None | $100.00 | $1,584.89 | $6,309.57 |
Blue Shield Setting Professional Modifier None Typical Low $117.49 Median $229.09 Typical High $537.03 | Professional | None | $117.49 | $229.09 | $537.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $446.68 | Professional | None | $131.83 | $177.83 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,584.89 Typical High $3,019.95 | Facility | None | $575.44 | $1,584.89 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $275.42 Typical High $575.44 | Professional | None | $151.36 | $275.42 | $575.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $436.52 | Professional | None | $125.89 | $165.96 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $331.13 Typical High $630.96 | Professional | None | $141.25 | $331.13 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $3,890.45 | Professional | None | $2,691.53 | $3,890.45 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $457.09 | Professional | None | $269.15 | $269.15 | $457.09 |
Providence Setting Facility Modifier None Typical Low $398.11 Median $1,513.56 Typical High $3,715.35 | Facility | None | $398.11 | $1,513.56 | $3,715.35 |
Providence Setting Professional Modifier None Typical Low $151.36 Median $275.42 Typical High $562.34 | Professional | None | $151.36 | $275.42 | $562.34 |
Sutter Health Plus Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $1,071.52 | Professional | None | $489.78 | $489.78 | $1,071.52 |
United Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $4,466.84 | Facility | None | $630.96 | $630.96 | $4,466.84 |
United Setting Professional Modifier None Typical Low $125.89 Median $295.12 Typical High $676.08 | Professional | None | $125.89 | $295.12 | $676.08 |
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 $79.43 Median $83.18 Typical High $177.83 | Facility | 52 · Reduced service | $79.43 | $83.18 | $177.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $31.62 Median $33.11 Typical High $70.79 | Facility | 53 · Discontinued | $31.62 | $33.11 | $70.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $123.03 Typical High $263.03 | Facility | 54 · Surgery only | $117.49 | $123.03 | $263.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $24.55 Typical High $53.70 | Facility | 55 · Aftercare only | $23.99 | $24.55 | $53.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.60 Typical High $35.48 | Facility | 56 · Pre-op care only | $15.85 | $16.60 | $35.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $138.04 Typical High $177.83 | Professional | 52 · Reduced service | $75.86 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $56.23 Typical High $70.79 | Professional | 53 · Discontinued | $30.20 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $208.93 Typical High $263.03 | Professional | 54 · Surgery only | $112.20 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $41.69 Typical High $53.70 | Professional | 55 · Aftercare only | $22.39 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $27.54 Typical High $35.48 | Professional | 56 · Pre-op care only | $15.14 | $27.54 | $35.48 |
Where California sits
The same service costs 3.0 times more in Wisconsin than in Utah. 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· 38th of 51
$324
WI $851UT $288
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.