How much rates vary
Facilitymedian $4,169 · 10th to 90th $417 to $12,882Professionalmedian $282 · 10th to 90th $145 to $2,344
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 $144.54 Median $269.15 Typical High $346.74 | Professional | None | $144.54 | $269.15 | $346.74 |
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 $144.54 Median $154.88 Typical High $691.83 | Professional | None | $144.54 | $154.88 | $691.83 |
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 $114.82 Median $218.78 Typical High $426.58 | Professional | None | $114.82 | $218.78 | $426.58 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $489.78 | Professional | None | $162.18 | $218.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $316.23 Typical High $537.03 | Professional | None | $165.96 | $316.23 | $537.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $478.63 | Professional | None | $128.82 | $165.96 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $323.59 Typical High $575.44 | Professional | None | $134.90 | $323.59 | $575.44 |
Lucent Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,344.23 | $2,884.03 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $257.04 Typical High $426.58 | Professional | None | $33.11 | $257.04 | $426.58 |
Providence Setting Facility Modifier None Typical Low $151.36 Median $309.03 Typical High $512.86 | Facility | None | $151.36 | $309.03 | $512.86 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $316.23 Typical High $537.03 | Professional | None | $165.96 | $316.23 | $537.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,122.02 | Professional | None | $524.81 | $524.81 | $1,122.02 |
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 $138.04 Median $288.40 Typical High $588.84 | Professional | None | $138.04 | $288.40 | $588.84 |
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 $75.86 Median $83.18 Typical High $173.78 | Facility | 52 · Reduced service | $75.86 | $83.18 | $173.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.20 Median $33.11 Typical High $69.18 | Facility | 53 · Discontinued | $30.20 | $33.11 | $69.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $123.03 Typical High $263.03 | Facility | 54 · Surgery only | $114.82 | $123.03 | $263.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $24.55 Typical High $52.48 | Facility | 55 · Aftercare only | $22.91 | $24.55 | $52.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.60 Typical High $34.67 | Facility | 56 · Pre-op care only | $15.14 | $16.60 | $34.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $128.82 Typical High $173.78 | Professional | 52 · Reduced service | $72.44 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $52.48 Typical High $69.18 | Professional | 53 · Discontinued | $28.84 | $52.48 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $194.98 Typical High $263.03 | Professional | 54 · Surgery only | $109.65 | $194.98 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $38.90 Typical High $52.48 | Professional | 55 · Aftercare only | $21.88 | $38.90 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $25.70 Typical High $34.67 | Professional | 56 · Pre-op care only | $14.45 | $25.70 | $34.67 |
Where California sits
The same service costs 3.5 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· 40th of 51
$282
AK $661VA $186
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.