How much rates vary
Facilitymedian $1,148 · 10th to 90th $427 to $5,370Professionalmedian $83 · 10th to 90th $65 to $1,122
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 $70.79 Median $75.86 Typical High $1,584.89 | Professional | None | $70.79 | $75.86 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,128.61 Typical High $10,471.29 | Facility | None | $2,137.96 | $5,128.61 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $302.00 | Professional | None | $77.62 | $85.11 | $302.00 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,778.28 Typical High $5,370.32 | Facility | None | $100.00 | $1,778.28 | $5,370.32 |
Blue Shield Setting Professional Modifier None Typical Low $56.23 Median $81.28 Typical High $186.21 | Professional | None | $56.23 | $81.28 | $186.21 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $223.87 | Professional | None | $85.11 | $131.83 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,862.09 Typical High $3,311.31 | Facility | None | $426.58 | $1,862.09 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $213.80 | Professional | None | $70.79 | $83.18 | $213.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $151.36 | Professional | None | $75.86 | $97.72 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $204.17 | Professional | None | $67.61 | $85.11 | $204.17 |
Lucent Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,698.24 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Providence Setting Facility Modifier None Typical Low $295.12 Median $1,778.28 Typical High $3,467.37 | Facility | None | $295.12 | $1,778.28 | $3,467.37 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $213.80 | Professional | None | $70.79 | $79.43 | $213.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $57.54 Median $81.28 Typical High $218.78 | Professional | None | $57.54 | $81.28 | $218.78 |
6 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 $35.48 Median $38.02 Typical High $41.69 | Professional | 52 · Reduced service | $35.48 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $15.14 Typical High $16.60 | Professional | 53 · Discontinued | $14.13 | $15.14 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $57.54 Typical High $61.66 | Professional | 54 · Surgery only | $53.70 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.48 Typical High $12.30 | Professional | 55 · Aftercare only | $10.72 | $11.48 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.59 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.08 | $7.59 | $8.32 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $89.13 Median $117.49 Typical High $275.42 | Professional | 50 · Both sides | $89.13 | $117.49 | $275.42 |
Where California sits
The same service costs 11.2 times more in Tennessee than in New York. 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· 13th of 51
$162
TN $832NY $74.13
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.