How much rates vary
Facilitymedian $631 · 10th to 90th $148 to $5,888Professionalmedian $170 · 10th to 90th $120 to $562
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 $112.20 Median $158.49 Typical High $295.12 | Professional | None | $112.20 | $158.49 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
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 $134.90 Median $190.55 Typical High $489.78 | Professional | None | $134.90 | $190.55 | $489.78 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $426.58 Typical High $1,584.89 | Facility | None | $97.72 | $426.58 | $1,584.89 |
Blue Shield Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $389.05 | Professional | None | $102.33 | $169.82 | $389.05 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $245.47 | Professional | None | $109.65 | $177.83 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $204.17 Typical High $758.58 | Facility | None | $128.82 | $204.17 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $316.23 | Professional | None | $123.03 | $158.49 | $316.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $239.88 | Professional | None | $117.49 | $141.25 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $199.53 Typical High $416.87 | Professional | None | $109.65 | $199.53 | $416.87 |
Lucent Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,288.25 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $257.04 | Professional | None | $151.36 | $151.36 | $257.04 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $239.88 Typical High $2,570.40 | Facility | None | $131.83 | $239.88 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $323.59 | Professional | None | $123.03 | $158.49 | $323.59 |
Sutter Health Plus Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
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 $100.00 Median $162.18 Typical High $407.38 | Professional | None | $100.00 | $162.18 | $407.38 |
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 $60.26 Median $61.66 Typical High $79.43 | Facility | 52 · Reduced service | $60.26 | $61.66 | $79.43 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $32.36 | Facility | 53 · Discontinued | $23.99 | $24.55 | $32.36 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $89.13 Median $91.20 Typical High $120.23 | Facility | 54 · Surgery only | $89.13 | $91.20 | $120.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $18.20 Typical High $23.99 | Facility | 55 · Aftercare only | $17.78 | $18.20 | $23.99 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $15.85 | Facility | 56 · Pre-op care only | $12.02 | $12.30 | $15.85 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $70.79 Typical High $79.43 | Professional | 52 · Reduced service | $56.23 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $28.18 Typical High $32.36 | Professional | 53 · Discontinued | $22.39 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $104.71 Typical High $120.23 | Professional | 54 · Surgery only | $83.18 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.89 Typical High $23.99 | Professional | 55 · Aftercare only | $16.60 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.13 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.22 | $14.13 | $15.85 |
Where California sits
The same service costs 3.7 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· 34th of 51
$186
WI $501KY $135
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.