How much rates vary
Facilitymedian $1,698 · 10th to 90th $98 to $6,761Professionalmedian $41 · 10th to 90th $28 to $132
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 $26.30 Median $38.02 Typical High $64.57 | Professional | None | $26.30 | $38.02 | $64.57 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $66.07 | Professional | None | $41.69 | $41.69 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $10,000.00 | Facility | None | $2,137.96 | $4,786.30 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $45.71 Typical High $123.03 | Professional | None | $35.48 | $45.71 | $123.03 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $1,778.28 Typical High $5,011.87 | Facility | None | $95.50 | $1,778.28 | $5,011.87 |
Blue Shield Setting Professional Modifier None Typical Low $24.55 Median $40.74 Typical High $93.33 | Professional | None | $24.55 | $40.74 | $93.33 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $25.12 Median $42.66 Typical High $52.48 | Professional | None | $25.12 | $42.66 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $575.44 Typical High $2,691.53 | Facility | None | $346.74 | $575.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $38.02 Typical High $72.44 | Professional | None | $28.84 | $38.02 | $72.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $26.92 Median $34.67 Typical High $51.29 | Professional | None | $26.92 | $34.67 | $51.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $25.70 Median $41.69 Typical High $91.20 | Professional | None | $25.70 | $41.69 | $91.20 |
Lucent Health Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $512.86 | Professional | None | $457.09 | $512.86 | $512.86 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $54.95 | Professional | None | $32.36 | $32.36 | $54.95 |
Providence Setting Facility Modifier None Typical Low $37.15 Median $338.84 Typical High $2,398.83 | Facility | None | $37.15 | $338.84 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $28.84 Median $37.15 Typical High $75.86 | Professional | None | $28.84 | $37.15 | $75.86 |
Sutter Health Plus Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $125.89 | Professional | None | $95.50 | $95.50 | $125.89 |
United Setting Facility Modifier None Typical Low $123.03 Median $501.19 Typical High $3,090.30 | Facility | None | $123.03 | $501.19 | $3,090.30 |
United Setting Professional Modifier None Typical Low $23.99 Median $38.02 Typical High $91.20 | Professional | None | $23.99 | $38.02 | $91.20 |
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 $14.13 Median $14.45 Typical High $19.50 | Facility | 52 · Reduced service | $14.13 | $14.45 | $19.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.75 Median $5.89 Typical High $7.76 | Facility | 53 · Discontinued | $5.75 | $5.89 | $7.76 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $21.38 Median $21.88 Typical High $28.84 | Facility | 54 · Surgery only | $21.38 | $21.88 | $28.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.27 Median $4.37 Typical High $5.75 | Facility | 55 · Aftercare only | $4.27 | $4.37 | $5.75 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.88 Typical High $3.89 | Facility | 56 · Pre-op care only | $2.82 | $2.88 | $3.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $16.98 Typical High $19.50 | Professional | 52 · Reduced service | $13.18 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $6.76 Typical High $7.76 | Professional | 53 · Discontinued | $5.37 | $6.76 | $7.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $25.12 Typical High $28.84 | Professional | 54 · Surgery only | $19.95 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $5.13 Typical High $5.75 | Professional | 55 · Aftercare only | $3.98 | $5.13 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $3.39 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.69 | $3.39 | $3.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $16.98 Median $22.39 Typical High $56.23 | Professional | 62 · Two surgeons | $16.98 | $22.39 | $56.23 |
Where California sits
The same service costs 3.3 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· 36th of 51
$42.66
AK $117KY $35.48
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.