How much rates vary
Facilitymedian $813 · 10th to 90th $427 to $5,129Professionalmedian $195 · 10th to 90th $117 to $457
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 $120.23 Median $194.98 Typical High $338.84 | Professional | None | $120.23 | $194.98 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $218.78 | Professional | None | $204.17 | $218.78 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $2,137.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $575.44 | Professional | None | $123.03 | $194.98 | $575.44 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,445.44 Typical High $4,897.79 | Facility | None | $100.00 | $1,445.44 | $4,897.79 |
Blue Shield Setting Professional Modifier None Typical Low $83.18 Median $158.49 Typical High $363.08 | Professional | None | $83.18 | $158.49 | $363.08 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $295.12 | Professional | None | $97.72 | $134.90 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,148.15 Typical High $2,344.23 | Facility | None | $426.58 | $1,148.15 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $363.08 | Professional | None | $120.23 | $199.53 | $363.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $288.40 | Professional | None | $93.33 | $131.83 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $229.09 Typical High $407.38 | Professional | None | $109.65 | $229.09 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $281.84 | Professional | None | $169.82 | $169.82 | $281.84 |
Providence Setting Facility Modifier None Typical Low $257.04 Median $1,122.02 Typical High $3,235.94 | Facility | None | $257.04 | $1,122.02 | $3,235.94 |
Providence Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $371.54 | Professional | None | $120.23 | $194.98 | $371.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $660.69 | Professional | None | $398.11 | $398.11 | $660.69 |
United Setting Facility Modifier None Typical Low $426.58 Median $446.68 Typical High $2,344.23 | Facility | None | $426.58 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $102.33 Median $186.21 Typical High $467.74 | Professional | None | $102.33 | $186.21 | $467.74 |
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 $63.10 Median $69.18 Typical High $117.49 | Facility | 52 · Reduced service | $63.10 | $69.18 | $117.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.70 Median $27.54 Typical High $46.77 | Facility | 53 · Discontinued | $25.70 | $27.54 | $46.77 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $95.50 Median $104.71 Typical High $173.78 | Facility | 54 · Surgery only | $95.50 | $104.71 | $173.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.05 Median $20.89 Typical High $35.48 | Facility | 55 · Aftercare only | $19.05 | $20.89 | $35.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.80 Typical High $23.44 | Facility | 56 · Pre-op care only | $12.88 | $13.80 | $23.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $93.33 Typical High $117.49 | Professional | 52 · Reduced service | $61.66 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $37.15 Typical High $46.77 | Professional | 53 · Discontinued | $25.12 | $37.15 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $138.04 Typical High $173.78 | Professional | 54 · Surgery only | $93.33 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $27.54 Typical High $35.48 | Professional | 55 · Aftercare only | $18.62 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $18.62 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.30 | $18.62 | $23.44 |
Where California sits
The same service costs 4.0 times more in Alaska 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· 34th of 51
$214
AK $631KY $158
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.