How much rates vary
Facilitymedian $2,818 · 10th to 90th $468 to $10,000Professionalmedian $162 · 10th to 90th $105 to $891
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 $104.71 Median $117.49 Typical High $147.91 | Professional | None | $104.71 | $117.49 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,454.71 Median $4,168.69 Typical High $9,120.11 | Facility | None | $2,454.71 | $4,168.69 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $457.09 | Professional | None | $162.18 | $169.82 | $457.09 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,606.93 | Facility | None | $67.61 | $3,090.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $323.59 | Professional | None | $100.00 | $141.25 | $323.59 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $131.83 | Professional | None | $89.13 | $125.89 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,174.90 Typical High $5,623.41 | Facility | None | $660.69 | $1,174.90 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $331.13 | Professional | None | $117.49 | $131.83 | $331.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $138.04 | Professional | None | $70.79 | $114.82 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $309.03 | Professional | None | $104.71 | $134.90 | $309.03 |
Lucent Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,047.13 | Professional | None | $891.25 | $891.25 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Providence Setting Facility Modifier None Typical Low $138.04 Median $870.96 Typical High $5,623.41 | Facility | None | $138.04 | $870.96 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $338.84 | Professional | None | $117.49 | $125.89 | $338.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $380.19 | Professional | None | $102.33 | $131.83 | $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 $52.48 Median $56.23 Typical High $61.66 | Professional | 52 · Reduced service | $52.48 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.39 Typical High $25.12 | Professional | 53 · Discontinued | $20.89 | $22.39 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $83.18 Typical High $93.33 | Professional | 54 · Surgery only | $79.43 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.60 Typical High $18.62 | Professional | 55 · Aftercare only | $15.85 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.22 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.47 | $11.22 | $12.30 |
Where California sits
The same service costs 3.9 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· 35th of 51
$174
AK $513NY $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.