How much rates vary
Facilitymedian $447 · 10th to 90th $91 to $6,918Professionalmedian $162 · 10th to 90th $120 to $447
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 $154.88 Median $7,079.46 Typical High $18,197.01 | Facility | None | $154.88 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $257.04 | Professional | None | $120.23 | $158.49 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $588.84 | Professional | None | $141.25 | $158.49 | $588.84 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $309.03 Typical High $4,570.88 | Facility | None | $100.00 | $309.03 | $4,570.88 |
Blue Shield Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $407.38 | Professional | None | $114.82 | $169.82 | $407.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $204.17 | Professional | None | $112.20 | $154.88 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $107.15 Typical High $223.87 | Facility | None | $53.70 | $107.15 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $295.12 | Professional | None | $131.83 | $158.49 | $295.12 |
Contra Costa Health Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $199.53 | Professional | None | $112.20 | $131.83 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $371.54 | Professional | None | $117.49 | $169.82 | $371.54 |
Lucent Health Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $234.42 | Professional | None | $138.04 | $138.04 | $234.42 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $125.89 Typical High $251.19 | Facility | None | $61.66 | $125.89 | $251.19 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $316.23 | Professional | None | $128.82 | $154.88 | $316.23 |
Sutter Health Plus Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $501.19 | Professional | None | $416.87 | $416.87 | $501.19 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,230.27 Typical High $4,677.35 | Facility | None | $398.11 | $1,230.27 | $4,677.35 |
United Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $380.19 | Professional | None | $109.65 | $162.18 | $380.19 |
9 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 $64.57 Median $66.07 Typical High $79.43 | Facility | 52 · Reduced service | $64.57 | $66.07 | $79.43 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.70 Median $26.30 Typical High $31.62 | Facility | 53 · Discontinued | $25.70 | $26.30 | $31.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.05 Median $19.50 Typical High $23.44 | Facility | 55 · Aftercare only | $19.05 | $19.50 | $23.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.18 Typical High $15.85 | Facility | 56 · Pre-op care only | $12.88 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $69.18 Typical High $79.43 | Professional | 52 · Reduced service | $60.26 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $27.54 Typical High $31.62 | Professional | 53 · Discontinued | $23.99 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $102.33 Typical High $117.49 | Professional | 54 · Surgery only | $89.13 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $20.42 Typical High $23.44 | Professional | 55 · Aftercare only | $17.78 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.02 | $13.80 | $15.85 |
Where California sits
The same service costs 2.9 times more in Alaska 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· 40th of 51
$166
AK $417KY $145
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.