How much rates vary
Facilitymedian $4,169 · 10th to 90th $427 to $12,882Professionalmedian $302 · 10th to 90th $148 to $2,455
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 $478.63 Median $5,128.61 Typical High $15,135.61 | Facility | None | $478.63 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $602.56 | Professional | None | $158.49 | $281.84 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,456.54 Typical High $14,125.38 | Facility | None | $2,884.03 | $6,456.54 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $758.58 | Professional | None | $147.91 | $162.18 | $758.58 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $120.23 Median $234.42 Typical High $457.09 | Professional | None | $120.23 | $234.42 | $457.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $537.03 | Professional | None | $162.18 | $218.78 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $323.59 Typical High $575.44 | Professional | None | $165.96 | $323.59 | $575.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $524.81 | Professional | None | $128.82 | $177.83 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $354.81 Typical High $630.96 | Professional | None | $144.54 | $354.81 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $2,454.71 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,454.71 | $3,162.28 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $288.40 Typical High $478.63 | Professional | None | $33.11 | $288.40 | $478.63 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $323.59 Typical High $588.84 | Facility | None | $158.49 | $323.59 | $588.84 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $323.59 Typical High $575.44 | Professional | None | $165.96 | $323.59 | $575.44 |
Sutter Health Plus Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,174.90 | Professional | None | $549.54 | $549.54 | $1,174.90 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $7,244.36 | Facility | None | $602.56 | $1,621.81 | $7,244.36 |
United Setting Professional Modifier None Typical Low $144.54 Median $302.00 Typical High $630.96 | Professional | None | $144.54 | $302.00 | $630.96 |
10 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 Facility Modifier 52 · Reduced service Typical Low $77.62 Median $85.11 Typical High $186.21 | Facility | 52 · Reduced service | $77.62 | $85.11 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $31.62 Median $33.88 Typical High $74.13 | Facility | 53 · Discontinued | $31.62 | $33.88 | $74.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $128.82 Typical High $275.42 | Facility | 54 · Surgery only | $117.49 | $128.82 | $275.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $25.70 Typical High $54.95 | Facility | 55 · Aftercare only | $23.44 | $25.70 | $54.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.98 Typical High $37.15 | Facility | 56 · Pre-op care only | $15.85 | $16.98 | $37.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $138.04 Typical High $186.21 | Professional | 52 · Reduced service | $74.13 | $138.04 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $54.95 Typical High $74.13 | Professional | 53 · Discontinued | $30.20 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $208.93 Typical High $275.42 | Professional | 54 · Surgery only | $112.20 | $208.93 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $41.69 Typical High $54.95 | Professional | 55 · Aftercare only | $22.39 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $27.54 Typical High $37.15 | Professional | 56 · Pre-op care only | $15.14 | $27.54 | $37.15 |
Where California sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 39th of 51
$302
AK $676VA $204
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.