How much rates vary
Facilitymedian $1,413 · 10th to 90th $115 to $6,310Professionalmedian $145 · 10th to 90th $98 to $457
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 $169.82 Median $5,128.61 Typical High $15,135.61 | Facility | None | $169.82 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $245.47 | Professional | None | $91.20 | $138.04 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $147.91 | Professional | None | $134.90 | $134.90 | $147.91 |
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 $117.49 Median $162.18 Typical High $426.58 | Professional | None | $117.49 | $162.18 | $426.58 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,238.72 Typical High $5,128.61 | Facility | None | $100.00 | $2,238.72 | $5,128.61 |
Blue Shield Setting Professional Modifier None Typical Low $87.10 Median $144.54 Typical High $331.13 | Professional | None | $87.10 | $144.54 | $331.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $204.17 | Professional | None | $77.62 | $107.15 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $169.82 Typical High $758.58 | Facility | None | $107.15 | $169.82 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $263.03 | Professional | None | $102.33 | $138.04 | $263.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $199.53 | Professional | None | $74.13 | $104.71 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $346.74 | Professional | None | $91.20 | $162.18 | $346.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,096.48 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $218.78 | Professional | None | $131.83 | $131.83 | $218.78 |
Providence Setting Facility Modifier None Typical Low $109.65 Median $204.17 Typical High $2,570.40 | Facility | None | $109.65 | $204.17 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $275.42 | Professional | None | $102.33 | $134.90 | $275.42 |
Sutter Health Plus Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $478.63 | Professional | None | $331.13 | $331.13 | $478.63 |
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 $85.11 Median $138.04 Typical High $338.84 | Professional | None | $85.11 | $138.04 | $338.84 |
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 $50.12 Median $51.29 Typical High $69.18 | Facility | 52 · Reduced service | $50.12 | $51.29 | $69.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $28.18 | Facility | 53 · Discontinued | $20.42 | $20.42 | $28.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $75.86 Median $77.62 Typical High $104.71 | Facility | 54 · Surgery only | $75.86 | $77.62 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $20.89 | Facility | 55 · Aftercare only | $15.14 | $15.49 | $20.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $14.13 | Facility | 56 · Pre-op care only | $10.00 | $10.23 | $14.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $61.66 Typical High $69.18 | Professional | 52 · Reduced service | $46.77 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $24.55 Typical High $28.18 | Professional | 53 · Discontinued | $18.62 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $91.20 Typical High $104.71 | Professional | 54 · Surgery only | $70.79 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $18.20 Typical High $20.89 | Professional | 55 · Aftercare only | $14.13 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.30 Typical High $14.13 | Professional | 56 · Pre-op care only | $9.33 | $12.30 | $14.13 |
Where California sits
The same service costs 3.2 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
$155
WI $417KY $129
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.