How much rates vary
Facilitymedian $468 · 10th to 90th $107 to $5,248Professionalmedian $117 · 10th to 90th $87 to $389
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 $645.65 Median $5,888.44 Typical High $15,848.93 | Facility | None | $645.65 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $112.20 Typical High $204.17 | Professional | None | $87.10 | $112.20 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $316.23 | Professional | None | $218.78 | $218.78 | $316.23 |
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 $95.50 Median $120.23 Typical High $354.81 | Professional | None | $95.50 | $120.23 | $354.81 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $426.58 Typical High $1,479.11 | Facility | None | $100.00 | $426.58 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $72.44 Median $114.82 Typical High $269.15 | Professional | None | $72.44 | $114.82 | $269.15 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $53.70 Median $102.33 Typical High $169.82 | Professional | None | $53.70 | $102.33 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $144.54 Typical High $758.58 | Facility | None | $91.20 | $144.54 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $229.09 | Professional | None | $91.20 | $114.82 | $229.09 |
Contra Costa Health Setting Professional Modifier None Typical Low $51.29 Median $102.33 Typical High $169.82 | Professional | None | $51.29 | $102.33 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $269.15 | Professional | None | $85.11 | $138.04 | $269.15 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,096.48 | Professional | None | $912.01 | $912.01 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $181.97 | Professional | None | $109.65 | $109.65 | $181.97 |
Providence Setting Facility Modifier None Typical Low $95.50 Median $173.78 Typical High $2,570.40 | Facility | None | $95.50 | $173.78 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $234.42 | Professional | None | $91.20 | $109.65 | $234.42 |
Sutter Health Plus Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
United Setting Facility Modifier None Typical Low $147.91 Median $467.74 Typical High $1,778.28 | Facility | None | $147.91 | $467.74 | $1,778.28 |
United Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $288.40 | Professional | None | $75.86 | $114.82 | $288.40 |
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 $45.71 Median $45.71 Typical High $56.23 | Facility | 52 · Reduced service | $45.71 | $45.71 | $56.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $18.62 Typical High $22.39 | Facility | 53 · Discontinued | $18.20 | $18.62 | $22.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $16.98 | Facility | 55 · Aftercare only | $13.80 | $13.80 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $11.22 | Facility | 56 · Pre-op care only | $9.12 | $9.12 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $48.98 Typical High $56.23 | Professional | 52 · Reduced service | $41.69 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $19.50 Typical High $22.39 | Professional | 53 · Discontinued | $16.98 | $19.50 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $74.13 Typical High $85.11 | Professional | 54 · Surgery only | $63.10 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.79 Typical High $16.98 | Professional | 55 · Aftercare only | $12.59 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.77 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.32 | $9.77 | $11.22 |
Where California sits
The same service costs 3.7 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· 41st of 51
$123
AK $372KY $100
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.