How much rates vary
Facilitymedian $692 · 10th to 90th $151 to $6,310Professionalmedian $55 · 10th to 90th $23 to $407
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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $22.91 Typical High $1,584.89 | Professional | None | $21.88 | $22.91 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,897.79 Typical High $10,000.00 | Facility | None | $2,511.89 | $4,897.79 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $58.88 Typical High $77.62 | Professional | None | $26.30 | $58.88 | $77.62 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $4,570.88 | Facility | None | $97.72 | $416.87 | $4,570.88 |
Blue Shield Setting Professional Modifier None Typical Low $30.20 Median $50.12 Typical High $100.00 | Professional | None | $30.20 | $50.12 | $100.00 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $40.74 Median $48.98 Typical High $72.44 | Professional | None | $40.74 | $48.98 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $295.12 Typical High $1,659.59 | Facility | None | $186.21 | $295.12 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $74.13 Typical High $181.97 | Professional | None | $35.48 | $74.13 | $181.97 |
Contra Costa Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $60.26 Typical High $107.15 | Professional | None | $41.69 | $60.26 | $107.15 |
Lucent Health Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $467.74 | Professional | None | $407.38 | $467.74 | $467.74 |
Providence Setting Facility Modifier None Typical Low $151.36 Median $354.81 Typical High $3,801.89 | Facility | None | $151.36 | $354.81 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $41.69 Median $81.28 Typical High $181.97 | Professional | None | $41.69 | $81.28 | $181.97 |
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 $17.38 Median $29.51 Typical High $107.15 | Professional | None | $17.38 | $29.51 | $107.15 |
5 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 Professional Modifier 52 · Reduced service Typical Low $10.96 Median $11.48 Typical High $11.75 | Professional | 52 · Reduced service | $10.96 | $11.48 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.57 Typical High $4.68 | Professional | 53 · Discontinued | $4.37 | $4.57 | $4.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $16.98 Typical High $18.62 | Professional | 54 · Surgery only | $16.22 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.47 Typical High $3.55 | Professional | 55 · Aftercare only | $3.24 | $3.47 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.29 Typical High $2.34 | Professional | 56 · Pre-op care only | $2.19 | $2.29 | $2.34 |
Where California sits
The same service costs 9.1 times more in Tennessee than in Maine. 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· 17th of 51
$112
TN $288ME $31.62
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.