How much rates vary
Facilitymedian $417 · 10th to 90th $66 to $5,623Professionalmedian $81 · 10th to 90th $50 to $269
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 $75.86 Median $4,897.79 Typical High $15,135.61 | Facility | None | $75.86 | $4,897.79 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $147.91 | Professional | None | $46.77 | $69.18 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $100.00 Typical High $112.20 | Professional | None | $50.12 | $100.00 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $57.54 Median $75.86 Typical High $3,890.45 | Facility | None | $57.54 | $75.86 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $83.18 Typical High $245.47 | Professional | None | $58.88 | $83.18 | $245.47 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $416.87 Typical High $1,548.82 | Facility | None | $91.20 | $416.87 | $1,548.82 |
Blue Shield Setting Professional Modifier None Typical Low $43.65 Median $74.13 Typical High $173.78 | Professional | None | $43.65 | $74.13 | $173.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $53.70 Median $151.36 Typical High $251.19 | Professional | None | $53.70 | $151.36 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $5,623.41 | Facility | None | $50.12 | $61.66 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $74.13 Typical High $177.83 | Professional | None | $50.12 | $74.13 | $177.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $204.17 | Professional | None | $134.90 | $169.82 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47.86 Median $128.82 Typical High $363.08 | Professional | None | $47.86 | $128.82 | $363.08 |
Lucent Health Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $912.01 | Professional | None | $776.25 | $776.25 | $912.01 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $316.23 | Professional | None | $190.55 | $190.55 | $316.23 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $74.13 Typical High $5,623.41 | Facility | None | $50.12 | $74.13 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $177.83 | Professional | None | $50.12 | $69.18 | $177.83 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $3,090.30 | Facility | None | $123.03 | $537.03 | $3,090.30 |
United Setting Professional Modifier None Typical Low $41.69 Median $77.62 Typical High $213.80 | Professional | None | $41.69 | $77.62 | $213.80 |
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 $25.70 Median $25.70 Typical High $38.02 | Facility | 52 · Reduced service | $25.70 | $25.70 | $38.02 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $15.14 | Facility | 53 · Discontinued | $10.23 | $10.23 | $15.14 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $38.02 Median $38.90 Typical High $57.54 | Facility | 54 · Surgery only | $38.02 | $38.90 | $57.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $11.48 | Facility | 55 · Aftercare only | $7.76 | $7.76 | $11.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $7.59 | Facility | 56 · Pre-op care only | $5.13 | $5.13 | $7.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $33.11 Typical High $38.02 | Professional | 52 · Reduced service | $23.99 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $13.18 Typical High $15.14 | Professional | 53 · Discontinued | $9.55 | $13.18 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $50.12 Typical High $57.54 | Professional | 54 · Surgery only | $35.48 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.00 Typical High $11.48 | Professional | 55 · Aftercare only | $7.08 | $10.00 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.61 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.79 | $6.61 | $7.59 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $50.12 Median $50.12 Typical High $398.11 | Professional | 51 · Multiple procedures | $50.12 | $50.12 | $398.11 |
Where California sits
The same service costs 3.2 times more in Alaska than in New York. 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· 49th of 51
$83.18
AK $251NY $77.62
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.