How much rates vary
Facilitymedian $646 · 10th to 90th $105 to $9,120Professionalmedian $105 · 10th to 90th $76 to $676
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 $79.43 Median $93.33 Typical High $112.20 | Professional | None | $79.43 | $93.33 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $112.20 Typical High $467.74 | Facility | None | $89.13 | $112.20 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $213.80 | Professional | None | $89.13 | $109.65 | $213.80 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $162.18 | Professional | None | $60.26 | $87.10 | $162.18 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $151.36 | Professional | None | $77.62 | $104.71 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $181.97 | Professional | None | $77.62 | $102.33 | $181.97 |
Contra Costa Health Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $151.36 | Professional | None | $61.66 | $91.20 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $223.87 | Professional | None | $75.86 | $117.49 | $223.87 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | None | $912.01 | $954.99 | $954.99 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Providence Setting Facility Modifier None Typical Low $83.18 Median $120.23 Typical High $181.97 | Facility | None | $83.18 | $120.23 | $181.97 |
Providence Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $186.21 | Professional | None | $75.86 | $97.72 | $186.21 |
Sutter Health Plus Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $331.13 | Professional | None | $257.04 | $257.04 | $331.13 |
United Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $3,981.07 | Facility | None | $549.54 | $549.54 | $3,981.07 |
United Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $190.55 | Professional | None | $66.07 | $100.00 | $190.55 |
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 $40.74 Median $44.67 Typical High $56.23 | Facility | 52 · Reduced service | $40.74 | $44.67 | $56.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $17.78 Typical High $22.39 | Facility | 53 · Discontinued | $16.22 | $17.78 | $22.39 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $61.66 Median $66.07 Typical High $83.18 | Facility | 54 · Surgery only | $61.66 | $66.07 | $83.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $13.49 Typical High $16.98 | Facility | 55 · Aftercare only | $12.30 | $13.49 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.91 Typical High $11.22 | Facility | 56 · Pre-op care only | $8.13 | $8.91 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $45.71 Typical High $56.23 | Professional | 52 · Reduced service | $38.90 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $18.20 Typical High $22.39 | Professional | 53 · Discontinued | $15.49 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $69.18 Typical High $83.18 | Professional | 54 · Surgery only | $57.54 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.80 Typical High $16.98 | Professional | 55 · Aftercare only | $11.48 | $13.80 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.12 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.76 | $9.12 | $11.22 |
Where California sits
The same service costs 3.8 times more in Alaska 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· 38th of 51
$105
AK $324FL $85.11
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.