How much rates vary
Facilitymedian $3,236 · 10th to 90th $912 to $11,220Professionalmedian $162 · 10th to 90th $117 to $813
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 $2,818.38 Median $8,912.51 Typical High $19,054.61 | Facility | None | $2,818.38 | $8,912.51 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $181.97 | Professional | None | $120.23 | $138.04 | $181.97 |
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 $158.49 Median $173.78 Typical High $524.81 | Professional | None | $158.49 | $173.78 | $524.81 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,905.46 Typical High $10,232.93 | Facility | None | $100.00 | $1,905.46 | $10,232.93 |
Blue Shield Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $346.74 | Professional | None | $114.82 | $162.18 | $346.74 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $229.09 | Professional | None | $114.82 | $141.25 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,691.53 Typical High $4,466.84 | Facility | None | $851.14 | $2,691.53 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $363.08 | Professional | None | $125.89 | $147.91 | $363.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $165.96 | Professional | None | $125.89 | $138.04 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $338.84 | Professional | None | $114.82 | $144.54 | $338.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $2,754.23 Typical High $6,025.60 | Facility | None | $371.54 | $2,754.23 | $6,025.60 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $363.08 | Professional | None | $123.03 | $144.54 | $363.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,365.16 | $14,454.40 |
United Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $380.19 | Professional | None | $104.71 | $144.54 | $380.19 |
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 $58.88 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $58.88 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $23.44 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $100.00 Typical High $100.00 | Professional | 54 · Surgery only | $87.10 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $17.78 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $11.75 | $13.18 | $13.18 |
Where California sits
The same service costs 10.7 times more in Oklahoma 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· 38th of 51
$178
OK $1,413NY $132
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.