How much rates vary
Facilitymedian $282 · 10th to 90th $135 to $5,495Professionalmedian $245 · 10th to 90th $178 to $1,514
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 $933.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $426.58 | Professional | None | $181.97 | $199.53 | $426.58 |
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 $218.78 Median $245.47 Typical High $776.25 | Professional | None | $218.78 | $245.47 | $776.25 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $302.00 Typical High $4,570.88 | Facility | None | $100.00 | $302.00 | $4,570.88 |
Blue Shield Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $562.34 | Professional | None | $169.82 | $245.47 | $562.34 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $257.04 | Professional | None | $151.36 | $204.17 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $269.15 Typical High $562.34 | Facility | None | $53.70 | $269.15 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $537.03 | Professional | None | $190.55 | $218.78 | $537.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $223.87 | Professional | None | $151.36 | $181.97 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $489.78 | Professional | None | $165.96 | $213.80 | $489.78 |
Lucent Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,513.56 | $1,513.56 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $263.03 Typical High $562.34 | Facility | None | $58.88 | $263.03 | $562.34 |
Providence Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $537.03 | Professional | None | $186.21 | $213.80 | $537.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
United Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $1,778.28 | Facility | None | $141.25 | $141.25 | $1,778.28 |
United Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $575.44 | Professional | None | $158.49 | $213.80 | $575.44 |
5 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 Professional Modifier 52 · Reduced service Typical Low $89.13 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $89.13 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $35.48 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $26.30 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $17.78 | $19.95 | $19.95 |
Where California sits
The same service costs 3.2 times more in Alaska than in Utah. 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
$245
AK $631UT $195
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.