How much rates vary
Facilitymedian $355 · 10th to 90th $62 to $3,981Professionalmedian $78 · 10th to 90th $45 to $224
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 $79.43 Median $6,918.31 Typical High $18,197.01 | Facility | None | $79.43 | $6,918.31 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $70.79 Typical High $114.82 | Professional | None | $41.69 | $70.79 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $63.10 Typical High $72.44 | Professional | None | $61.66 | $63.10 | $72.44 |
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 $52.48 Median $85.11 Typical High $208.93 | Professional | None | $52.48 | $85.11 | $208.93 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $1,479.11 | Facility | None | $97.72 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $39.81 Median $70.79 Typical High $158.49 | Professional | None | $39.81 | $70.79 | $158.49 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $37.15 Median $48.98 Typical High $95.50 | Professional | None | $37.15 | $48.98 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $61.66 Typical High $123.03 | Facility | None | $47.86 | $61.66 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $74.13 Typical High $128.82 | Professional | None | $46.77 | $74.13 | $128.82 |
Contra Costa Health Setting Professional Modifier None Typical Low $37.15 Median $46.77 Typical High $93.33 | Professional | None | $37.15 | $46.77 | $93.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $40.74 Median $75.86 Typical High $165.96 | Professional | None | $40.74 | $75.86 | $165.96 |
Lucent Health Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $602.56 | Professional | None | $537.03 | $537.03 | $602.56 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $104.71 | Professional | None | $63.10 | $63.10 | $104.71 |
Providence Setting Facility Modifier None Typical Low $47.86 Median $64.57 Typical High $123.03 | Facility | None | $47.86 | $64.57 | $123.03 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $74.13 Typical High $131.83 | Professional | None | $46.77 | $74.13 | $131.83 |
Sutter Health Plus Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $223.87 | Professional | None | $151.36 | $151.36 | $223.87 |
United Setting Facility Modifier None Typical Low $194.98 Median $354.81 Typical High $1,096.48 | Facility | None | $194.98 | $354.81 | $1,096.48 |
United Setting Professional Modifier None Typical Low $38.90 Median $67.61 Typical High $158.49 | Professional | None | $38.90 | $67.61 | $158.49 |
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 $22.91 Median $23.44 Typical High $40.74 | Facility | 52 · Reduced service | $22.91 | $23.44 | $40.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.12 Median $9.33 Typical High $16.60 | Facility | 53 · Discontinued | $9.12 | $9.33 | $16.60 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $34.67 Median $35.48 Typical High $61.66 | Facility | 54 · Surgery only | $34.67 | $35.48 | $61.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.92 Median $7.08 Typical High $12.30 | Facility | 55 · Aftercare only | $6.92 | $7.08 | $12.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.68 Typical High $8.13 | Facility | 56 · Pre-op care only | $4.57 | $4.68 | $8.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $32.36 Typical High $40.74 | Professional | 52 · Reduced service | $21.38 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $12.88 Typical High $16.60 | Professional | 53 · Discontinued | $8.51 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $48.98 Typical High $61.66 | Professional | 54 · Surgery only | $32.36 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $9.77 Typical High $12.30 | Professional | 55 · Aftercare only | $6.46 | $9.77 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.46 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.27 | $6.46 | $8.13 |
Where California sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 27th of 51
$81.28
WI $200DC $64.57
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.