How much rates vary
Facilitymedian $617 · 10th to 90th $141 to $6,310Professionalmedian $182 · 10th to 90th $135 to $794
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 $144.54 Median $169.82 Typical High $199.53 | Professional | None | $144.54 | $169.82 | $199.53 |
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 $147.91 Median $181.97 Typical High $537.03 | Professional | None | $147.91 | $181.97 | $537.03 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $309.03 Typical High $4,570.88 | Facility | None | $100.00 | $309.03 | $4,570.88 |
Blue Shield Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $398.11 | Professional | None | $112.20 | $165.96 | $398.11 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $251.19 | Professional | None | $128.82 | $158.49 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $194.98 Typical High $758.58 | Facility | None | $120.23 | $194.98 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $346.74 | Professional | None | $141.25 | $173.78 | $346.74 |
Contra Costa Health Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $269.15 | Professional | None | $141.25 | $190.55 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $436.52 | Professional | None | $131.83 | $199.53 | $436.52 |
Lucent Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,318.26 | $1,584.89 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $239.88 Typical High $2,570.40 | Facility | None | $125.89 | $239.88 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $363.08 | Professional | None | $141.25 | $173.78 | $363.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $575.44 | Professional | None | $457.09 | $457.09 | $575.44 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,230.27 Typical High $4,677.35 | Facility | None | $398.11 | $1,230.27 | $4,677.35 |
United Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $436.52 | Professional | None | $117.49 | $177.83 | $436.52 |
11 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 $72.44 Median $79.43 Typical High $100.00 | Facility | 52 · Reduced service | $72.44 | $79.43 | $100.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $29.51 Median $31.62 Typical High $39.81 | Facility | 53 · Discontinued | $29.51 | $31.62 | $39.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $109.65 Median $117.49 Typical High $151.36 | Facility | 54 · Surgery only | $109.65 | $117.49 | $151.36 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.88 Median $23.44 Typical High $30.20 | Facility | 55 · Aftercare only | $21.88 | $23.44 | $30.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.85 Typical High $19.95 | Facility | 56 · Pre-op care only | $14.79 | $15.85 | $19.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $83.18 Typical High $100.00 | Professional | 52 · Reduced service | $72.44 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $28.84 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $123.03 Typical High $151.36 | Professional | 54 · Surgery only | $107.15 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $24.55 Typical High $30.20 | Professional | 55 · Aftercare only | $21.38 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.60 Typical High $19.95 | Professional | 56 · Pre-op care only | $14.45 | $16.60 | $19.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $83.18 Median $107.15 Typical High $186.21 | Professional | 62 · Two surgeons | $83.18 | $107.15 | $186.21 |
Where California sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 39th of 51
$191
AK $575PA $170
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.