How much rates vary
Facilitymedian $1,096 · 10th to 90th $398 to $6,310Professionalmedian $148 · 10th to 90th $95 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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $102.33 Typical High $1,584.89 | Professional | None | $95.50 | $102.33 | $1,584.89 |
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 $144.54 Median $154.88 Typical High $436.52 | Professional | None | $144.54 | $154.88 | $436.52 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $933.25 Typical High $4,570.88 | Facility | None | $100.00 | $933.25 | $4,570.88 |
Blue Shield Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $281.84 | Professional | None | $81.28 | $114.82 | $281.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $158.49 | Professional | None | $87.10 | $125.89 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $645.65 Typical High $1,479.11 | Facility | None | $426.58 | $645.65 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $309.03 | Professional | None | $97.72 | $117.49 | $309.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $144.54 | Professional | None | $85.11 | $120.23 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $316.23 | Professional | None | $107.15 | $134.90 | $316.23 |
Lucent Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,000.00 | Professional | None | $794.33 | $794.33 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $691.83 Typical High $2,754.23 | Facility | None | $331.13 | $691.83 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $309.03 | Professional | None | $97.72 | $117.49 | $309.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $4,677.35 | Facility | None | $398.11 | $1,202.26 | $4,677.35 |
United Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $346.74 | Professional | None | $91.20 | $117.49 | $346.74 |
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 $47.86 Median $51.29 Typical High $56.23 | Professional | 52 · Reduced service | $47.86 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $20.42 Typical High $22.39 | Professional | 53 · Discontinued | $19.05 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $75.86 Typical High $85.11 | Professional | 54 · Surgery only | $72.44 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.14 Typical High $16.98 | Professional | 55 · Aftercare only | $14.45 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.23 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.55 | $10.23 | $11.22 |
Where California sits
The same service costs 4.4 times more in Alaska 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· 24th of 51
$191
AK $513NY $117
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.