How much rates vary
Facilitymedian $589 · 10th to 90th $76 to $6,310Professionalmedian $76 · 10th to 90th $41 to $219
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 $81.28 Median $7,079.46 Typical High $18,197.01 | Facility | None | $81.28 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $70.79 Typical High $131.83 | Professional | None | $39.81 | $70.79 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
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 $45.71 Median $81.28 Typical High $199.53 | Professional | None | $45.71 | $81.28 | $199.53 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $416.87 Typical High $1,479.11 | Facility | None | $95.50 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $32.36 Median $66.07 Typical High $147.91 | Professional | None | $32.36 | $66.07 | $147.91 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $45.71 Median $95.50 Typical High $138.04 | Professional | None | $45.71 | $95.50 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $676.08 | Facility | None | $50.12 | $61.66 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $69.18 Typical High $134.90 | Professional | None | $39.81 | $69.18 | $134.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $44.67 Median $75.86 Typical High $114.82 | Professional | None | $44.67 | $75.86 | $114.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $83.18 Typical High $154.88 | Professional | None | $37.15 | $83.18 | $154.88 |
Lucent Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $104.71 | Professional | None | $63.10 | $63.10 | $104.71 |
Providence Setting Facility Modifier None Typical Low $45.71 Median $75.86 Typical High $676.08 | Facility | None | $45.71 | $75.86 | $676.08 |
Providence Setting Professional Modifier None Typical Low $39.81 Median $69.18 Typical High $138.04 | Professional | None | $39.81 | $69.18 | $138.04 |
Sutter Health Plus Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $229.09 | Professional | None | $131.83 | $131.83 | $229.09 |
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 $33.88 Median $67.61 Typical High $162.18 | Professional | None | $33.88 | $67.61 | $162.18 |
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 $21.88 Median $22.91 Typical High $43.65 | Facility | 52 · Reduced service | $21.88 | $22.91 | $43.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.71 Median $9.12 Typical High $17.78 | Facility | 53 · Discontinued | $8.71 | $9.12 | $17.78 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $32.36 Median $33.88 Typical High $66.07 | Facility | 54 · Surgery only | $32.36 | $33.88 | $66.07 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.46 Median $6.76 Typical High $13.18 | Facility | 55 · Aftercare only | $6.46 | $6.76 | $13.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.57 Typical High $8.91 | Facility | 56 · Pre-op care only | $4.37 | $4.57 | $8.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $34.67 Typical High $41.69 | Professional | 52 · Reduced service | $20.89 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $13.80 Typical High $16.60 | Professional | 53 · Discontinued | $8.32 | $13.80 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $52.48 Typical High $63.10 | Professional | 54 · Surgery only | $30.90 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $10.47 Typical High $12.59 | Professional | 55 · Aftercare only | $6.17 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.92 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.17 | $6.92 | $8.32 |
Where California sits
The same service costs 3.4 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· 28th of 51
$81.28
WI $209KY $61.66
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.