How much rates vary
Facilitymedian $457 · 10th to 90th $79 to $5,495Professionalmedian $91 · 10th to 90th $56 to $295
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 $89.13 Median $7,079.46 Typical High $18,197.01 | Facility | None | $89.13 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $151.36 | Professional | None | $53.70 | $77.62 | $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 $70.79 Median $104.71 Typical High $257.04 | Professional | None | $70.79 | $104.71 | $257.04 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $426.58 Typical High $1,479.11 | Facility | None | $97.72 | $426.58 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $48.98 Median $85.11 Typical High $194.98 | Professional | None | $48.98 | $85.11 | $194.98 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $48.98 Median $93.33 Typical High $125.89 | Professional | None | $48.98 | $93.33 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $109.65 Typical High $758.58 | Facility | None | $67.61 | $109.65 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $158.49 | Professional | None | $57.54 | $85.11 | $158.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $134.90 | Professional | None | $52.48 | $74.13 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $50.12 Median $102.33 Typical High $218.78 | Professional | None | $50.12 | $102.33 | $218.78 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $794.33 | Professional | None | $660.69 | $660.69 | $794.33 |
Providence Setting Facility Modifier None Typical Low $67.61 Median $128.82 Typical High $2,570.40 | Facility | None | $67.61 | $128.82 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $162.18 | Professional | None | $57.54 | $85.11 | $162.18 |
Sutter Health Plus Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $295.12 | Professional | None | $190.55 | $190.55 | $295.12 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $47.86 Median $83.18 Typical High $204.17 | Professional | None | $47.86 | $83.18 | $204.17 |
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 $28.18 Median $28.84 Typical High $45.71 | Facility | 52 · Reduced service | $28.18 | $28.84 | $45.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.48 Median $11.75 Typical High $18.20 | Facility | 53 · Discontinued | $11.48 | $11.75 | $18.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $42.66 Median $43.65 Typical High $67.61 | Facility | 54 · Surgery only | $42.66 | $43.65 | $67.61 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.51 Median $8.71 Typical High $13.49 | Facility | 55 · Aftercare only | $8.51 | $8.71 | $13.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.89 Typical High $9.12 | Facility | 56 · Pre-op care only | $5.75 | $5.89 | $9.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $38.90 Typical High $45.71 | Professional | 52 · Reduced service | $26.92 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $15.85 Typical High $18.20 | Professional | 53 · Discontinued | $10.72 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $58.88 Typical High $67.61 | Professional | 54 · Surgery only | $39.81 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $11.75 Typical High $13.49 | Professional | 55 · Aftercare only | $7.94 | $11.75 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.76 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.37 | $7.76 | $9.12 |
Where California sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 30th of 51
$97.72
WI $240DC $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.