How much rates vary
Facilitymedian $1,000 · 10th to 90th $162 to $5,754Professionalmedian $138 · 10th to 90th $71 to $427
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 $72.44 Median $123.03 Typical High $245.47 | Professional | None | $72.44 | $123.03 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $151.36 | Professional | None | $138.04 | $144.54 | $151.36 |
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 $83.18 Median $144.54 Typical High $389.05 | Professional | None | $83.18 | $144.54 | $389.05 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,737.80 Typical High $4,897.79 | Facility | None | $100.00 | $1,737.80 | $4,897.79 |
Blue Shield Setting Professional Modifier None Typical Low $53.70 Median $112.20 Typical High $263.03 | Professional | None | $53.70 | $112.20 | $263.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $41.69 Median $87.10 Typical High $218.78 | Professional | None | $41.69 | $87.10 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $223.87 Typical High $1,412.54 | Facility | None | $141.25 | $223.87 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $128.82 Typical High $275.42 | Professional | None | $74.13 | $128.82 | $275.42 |
Contra Costa Health Setting Professional Modifier None Typical Low $40.74 Median $85.11 Typical High $213.80 | Professional | None | $40.74 | $85.11 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $162.18 Typical High $338.84 | Professional | None | $70.79 | $162.18 | $338.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,071.52 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $213.80 | Professional | None | $128.82 | $128.82 | $213.80 |
Providence Setting Facility Modifier None Typical Low $128.82 Median $269.15 Typical High $2,454.71 | Facility | None | $128.82 | $269.15 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $74.13 Median $128.82 Typical High $263.03 | Professional | None | $74.13 | $128.82 | $263.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $478.63 | Professional | None | $245.47 | $245.47 | $478.63 |
United Setting Facility Modifier None Typical Low $446.68 Median $524.81 Typical High $3,090.30 | Facility | None | $446.68 | $524.81 | $3,090.30 |
United Setting Professional Modifier None Typical Low $60.26 Median $123.03 Typical High $323.59 | Professional | None | $60.26 | $123.03 | $323.59 |
11 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 $38.02 Median $38.02 Typical High $72.44 | Facility | 52 · Reduced service | $38.02 | $38.02 | $72.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $28.84 | Facility | 53 · Discontinued | $15.14 | $15.14 | $28.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $56.23 Median $57.54 Typical High $107.15 | Facility | 54 · Surgery only | $56.23 | $57.54 | $107.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $21.38 | Facility | 55 · Aftercare only | $11.48 | $11.48 | $21.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $14.45 | Facility | 56 · Pre-op care only | $7.59 | $7.59 | $14.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $60.26 Typical High $72.44 | Professional | 52 · Reduced service | $34.67 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $23.99 Typical High $28.84 | Professional | 53 · Discontinued | $13.80 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $89.13 Typical High $107.15 | Professional | 54 · Surgery only | $52.48 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $18.20 Typical High $21.38 | Professional | 55 · Aftercare only | $10.47 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $12.02 Typical High $14.45 | Professional | 56 · Pre-op care only | $6.92 | $12.02 | $14.45 |
Ambetter Setting Professional Modifier AG · Primary physician Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | AG · Primary physician | $162.18 | $162.18 | $162.18 |
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· 31st of 51
$148
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.