How much rates vary
Facilitymedian $1,096 · 10th to 90th $398 to $6,310Professionalmedian $158 · 10th to 90th $91 to $832
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 $97.72 Median $104.71 Typical High $1,584.89 | Professional | None | $97.72 | $104.71 | $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 $125.89 Median $162.18 Typical High $416.87 | Professional | None | $125.89 | $162.18 | $416.87 |
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 $83.18 Median $117.49 Typical High $281.84 | Professional | None | $83.18 | $117.49 | $281.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $125.89 | Professional | None | $61.66 | $100.00 | $125.89 |
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 $81.28 Median $114.82 Typical High $288.40 | Professional | None | $81.28 | $114.82 | $288.40 |
Contra Costa Health Setting Professional Modifier None Typical Low $58.88 Median $114.82 Typical High $138.04 | Professional | None | $58.88 | $114.82 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $302.00 | Professional | None | $102.33 | $128.82 | $302.00 |
Lucent Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $954.99 | Professional | None | $831.76 | $831.76 | $954.99 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
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 $81.28 Median $112.20 Typical High $288.40 | Professional | None | $81.28 | $112.20 | $288.40 |
Sutter Health Plus Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
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 $83.18 Median $117.49 Typical High $316.23 | Professional | None | $83.18 | $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 $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 $20.89 Typical High $22.39 | Professional | 53 · Discontinued | $19.05 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $77.62 Typical High $83.18 | Professional | 54 · Surgery only | $70.79 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $15.49 Typical High $16.60 | Professional | 55 · Aftercare only | $14.13 | $15.49 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.47 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.55 | $10.47 | $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· 21st of 51
$195
AK $479NY $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.