How much rates vary
Facilitymedian $501 · 10th to 90th $110 to $5,623Professionalmedian $126 · 10th to 90th $87 to $407
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 $83.18 Median $117.49 Typical High $213.80 | Professional | None | $83.18 | $117.49 | $213.80 |
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 $102.33 Median $141.25 Typical High $371.54 | Professional | None | $102.33 | $141.25 | $371.54 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $426.58 Typical High $1,479.11 | Facility | None | $97.72 | $426.58 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $74.13 Median $123.03 Typical High $281.84 | Professional | None | $74.13 | $123.03 | $281.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $204.17 | Professional | None | $97.72 | $154.88 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $162.18 Typical High $758.58 | Facility | None | $102.33 | $162.18 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $234.42 | Professional | None | $91.20 | $120.23 | $234.42 |
Contra Costa Health Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $186.21 | Professional | None | $89.13 | $134.90 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $151.36 Typical High $316.23 | Professional | None | $83.18 | $151.36 | $316.23 |
Lucent Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,202.26 | Professional | None | $954.99 | $954.99 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $190.55 | Professional | None | $114.82 | $114.82 | $190.55 |
Providence Setting Facility Modifier None Typical Low $102.33 Median $181.97 Typical High $2,570.40 | Facility | None | $102.33 | $181.97 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $239.88 | Professional | None | $89.13 | $117.49 | $239.88 |
Sutter Health Plus Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | None | $295.12 | $295.12 | $407.38 |
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 $74.13 Median $120.23 Typical High $302.00 | Professional | None | $74.13 | $120.23 | $302.00 |
9 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 $43.65 Median $44.67 Typical High $60.26 | Facility | 52 · Reduced service | $43.65 | $44.67 | $60.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $23.99 | Facility | 53 · Discontinued | $17.78 | $17.78 | $23.99 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.18 Median $13.49 Typical High $17.78 | Facility | 55 · Aftercare only | $13.18 | $13.49 | $17.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.91 Typical High $12.02 | Facility | 56 · Pre-op care only | $8.71 | $8.91 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $52.48 Typical High $60.26 | Professional | 52 · Reduced service | $41.69 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $20.89 Typical High $23.99 | Professional | 53 · Discontinued | $16.60 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $77.62 Typical High $89.13 | Professional | 54 · Surgery only | $61.66 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.49 Typical High $17.78 | Professional | 55 · Aftercare only | $12.30 | $15.49 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.47 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.32 | $10.47 | $12.02 |
Where California sits
The same service costs 3.3 times more in Wisconsin 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· 38th of 51
$135
WI $372KY $112
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.