How much rates vary
Facilitymedian $2,692 · 10th to 90th $646 to $12,303Professionalmedian $6,761 · 10th to 90th $40 to $35,481
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 $4,570.88 Median $8,128.31 Typical High $19,054.61 | Facility | None | $4,570.88 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $6,606.93 Median $6,760.83 Typical High $7,943.28 | Professional | None | $6,606.93 | $6,760.83 | $7,943.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $11,748.98 Typical High $21,379.62 | Facility | None | $6,025.60 | $11,748.98 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,311.31 Median $5,888.44 Typical High $14,454.40 | Professional | None | $3,311.31 | $5,888.44 | $14,454.40 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $2,041.74 Typical High $5,495.41 | Facility | None | $91.20 | $2,041.74 | $5,495.41 |
Blue Shield Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,630.27 Typical High $5,370.32 | Facility | None | $758.58 | $2,630.27 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $4,073.80 Median $5,888.44 Typical High $15,488.17 | Professional | None | $4,073.80 | $5,888.44 | $15,488.17 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $407.38 Typical High $1,737.80 | Professional | None | $141.25 | $407.38 | $1,737.80 |
Lucent Health Setting Professional Modifier None Typical Low $30,902.95 Median $30,902.95 Typical High $35,481.34 | Professional | None | $30,902.95 | $30,902.95 | $35,481.34 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,691.53 Typical High $5,623.41 | Facility | None | $812.83 | $2,691.53 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $4,073.80 Median $5,495.41 Typical High $19,054.61 | Professional | None | $4,073.80 | $5,495.41 | $19,054.61 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $3,090.30 Median $4,365.16 Typical High $14,125.38 | Professional | None | $3,090.30 | $4,365.16 | $14,125.38 |
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 $2,754.23 Median $3,388.44 Typical High $3,388.44 | Professional | 52 · Reduced service | $2,754.23 | $3,388.44 | $3,388.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,096.48 Median $1,380.38 Typical High $1,380.38 | Professional | 53 · Discontinued | $1,096.48 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,073.80 Median $5,128.61 Typical High $5,128.61 | Professional | 54 · Surgery only | $4,073.80 | $5,128.61 | $5,128.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $812.83 Median $1,023.29 Typical High $1,023.29 | Professional | 55 · Aftercare only | $812.83 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | 56 · Pre-op care only | $549.54 | $676.08 | $676.08 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $15,848.93 Median $15,848.93 Typical High $15,848.93 | Professional | 51 · Multiple procedures | $15,848.93 | $15,848.93 | $15,848.93 |
Where California sits
The same service costs 4.4 times more in Alaska than in Arkansas. 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· 29th of 51
$4,467
AK $14,125AR $3,236
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.