How much rates vary
Facilitymedian $646 · 10th to 90th $81 to $5,754Professionalmedian $93 · 10th to 90th $65 to $245
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 $478.63 Median $5,128.61 Typical High $15,135.61 | Facility | None | $478.63 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $154.88 | Professional | None | $67.61 | $87.10 | $154.88 |
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 $72.44 Median $97.72 Typical High $245.47 | Professional | None | $72.44 | $97.72 | $245.47 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,348.96 Typical High $5,495.41 | Facility | None | $100.00 | $1,348.96 | $5,495.41 |
Blue Shield Setting Professional Modifier None Typical Low $52.48 Median $91.20 Typical High $208.93 | Professional | None | $52.48 | $91.20 | $208.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $69.18 Median $109.65 Typical High $158.49 | Professional | None | $69.18 | $109.65 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $100.00 Typical High $758.58 | Facility | None | $63.10 | $100.00 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $169.82 | Professional | None | $63.10 | $87.10 | $169.82 |
Contra Costa Health Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $131.83 | Professional | None | $61.66 | $87.10 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $57.54 Median $100.00 Typical High $181.97 | Professional | None | $57.54 | $100.00 | $181.97 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $125.89 | Professional | None | $75.86 | $75.86 | $125.89 |
Providence Setting Facility Modifier None Typical Low $64.57 Median $128.82 Typical High $2,454.71 | Facility | None | $64.57 | $128.82 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $173.78 | Professional | None | $63.10 | $85.11 | $173.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $281.84 | Professional | None | $208.93 | $208.93 | $281.84 |
United Setting Facility Modifier None Typical Low $147.91 Median $501.19 Typical High $1,737.80 | Facility | None | $147.91 | $501.19 | $1,737.80 |
United Setting Professional Modifier None Typical Low $54.95 Median $87.10 Typical High $208.93 | Professional | None | $54.95 | $87.10 | $208.93 |
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 $33.88 Median $35.48 Typical High $50.12 | Facility | 52 · Reduced service | $33.88 | $35.48 | $50.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.80 Median $14.13 Typical High $19.95 | Facility | 53 · Discontinued | $13.80 | $14.13 | $19.95 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $51.29 Median $53.70 Typical High $74.13 | Facility | 54 · Surgery only | $51.29 | $53.70 | $74.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.23 Median $10.72 Typical High $14.79 | Facility | 55 · Aftercare only | $10.23 | $10.72 | $14.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.08 Typical High $10.00 | Facility | 56 · Pre-op care only | $6.76 | $7.08 | $10.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $40.74 Typical High $50.12 | Professional | 52 · Reduced service | $32.36 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $16.22 Typical High $19.95 | Professional | 53 · Discontinued | $13.18 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $61.66 Typical High $74.13 | Professional | 54 · Surgery only | $48.98 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $12.30 Typical High $14.79 | Professional | 55 · Aftercare only | $9.77 | $12.30 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.13 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.46 | $8.13 | $10.00 |
Where California sits
The same service costs 3.5 times more in Wisconsin 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· 36th of 51
$97.72
WI $269FL $75.86
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.