How much rates vary
Facilitymedian $355 · 10th to 90th $100 to $6,166Professionalmedian $126 · 10th to 90th $93 to $794
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 $93.33 Median $100.00 Typical High $114.82 | Professional | None | $93.33 | $100.00 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $10,000.00 | Facility | None | $2,137.96 | $4,786.30 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $128.82 Typical High $426.58 | Professional | None | $112.20 | $128.82 | $426.58 |
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 $83.18 Median $117.49 Typical High $288.40 | Professional | None | $83.18 | $117.49 | $288.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $109.65 | Professional | None | $74.13 | $97.72 | $109.65 |
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 $100.00 Median $120.23 Typical High $281.84 | Professional | None | $100.00 | $120.23 | $281.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $57.54 Median $100.00 Typical High $117.49 | Professional | None | $57.54 | $100.00 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $263.03 | Professional | None | $91.20 | $117.49 | $263.03 |
Lucent Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $870.96 | Professional | None | $794.33 | $794.33 | $870.96 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $251.19 Typical High $562.34 | Facility | None | $58.88 | $251.19 | $562.34 |
Providence Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $295.12 | Professional | None | $95.50 | $120.23 | $295.12 |
Sutter Health Plus Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
United Setting Facility Modifier None Typical Low $123.03 Median $501.19 Typical High $3,090.30 | Facility | None | $123.03 | $501.19 | $3,090.30 |
United Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $316.23 | Professional | None | $89.13 | $117.49 | $316.23 |
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 $46.77 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $46.77 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $18.62 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $74.13 Typical High $74.13 | Professional | 54 · Surgery only | $69.18 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.79 Typical High $15.14 | Professional | 55 · Aftercare only | $13.80 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.33 | $10.00 | $10.00 |
Where California sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 29th of 51
$158
AK $355TX $110
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.