How much rates vary
Facilitymedian $1,072 · 10th to 90th $309 to $6,026Professionalmedian $126 · 10th to 90th $87 to $490
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 $85.11 Median $93.33 Typical High $173.78 | Facility | None | $85.11 | $93.33 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $141.25 | Professional | None | $85.11 | $97.72 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $2,137.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $489.78 | Professional | None | $125.89 | $138.04 | $489.78 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $436.52 Typical High $1,949.84 | Facility | None | $100.00 | $436.52 | $1,949.84 |
Blue Shield Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $288.40 | Professional | None | $87.10 | $125.89 | $288.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | None | $89.13 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $2,570.40 Typical High $4,466.84 | Facility | None | $426.58 | $2,570.40 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $281.84 | Professional | None | $95.50 | $109.65 | $281.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $131.83 | Professional | None | $97.72 | $107.15 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $257.04 | Professional | None | $89.13 | $112.20 | $257.04 |
Lucent Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Providence Setting Facility Modifier None Typical Low $93.33 Median $123.03 Typical High $208.93 | Facility | None | $93.33 | $123.03 | $208.93 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $169.82 Typical High $269.15 | Professional | None | $89.13 | $169.82 | $269.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
United Setting Facility Modifier None Typical Low $602.56 Median $933.25 Typical High $7,585.78 | Facility | None | $602.56 | $933.25 | $7,585.78 |
United Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $316.23 | Professional | None | $81.28 | $109.65 | $316.23 |
4 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 $42.66 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $42.66 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $16.98 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $12.88 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $9.33 |
Where California sits
The same service costs 7.9 times more in Kansas 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· 36th of 51
$138
KS $832NY $105
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.