How much rates vary
Facilitymedian $4,074 · 10th to 90th $245 to $11,220Professionalmedian $245 · 10th to 90th $120 to $2,138
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 $114.82 Median $223.87 Typical High $281.84 | Professional | None | $114.82 | $223.87 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,951.21 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $954.99 | Professional | None | $154.88 | $218.78 | $954.99 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $2,818.38 Typical High $6,309.57 | Facility | None | $69.18 | $2,818.38 | $6,309.57 |
Blue Shield Setting Professional Modifier None Typical Low $97.72 Median $199.53 Typical High $398.11 | Professional | None | $97.72 | $199.53 | $398.11 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $363.08 | Professional | None | $109.65 | $165.96 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $245.47 Typical High $426.58 | Professional | None | $125.89 | $245.47 | $426.58 |
Contra Costa Health Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $354.81 | Professional | None | $109.65 | $131.83 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $239.88 Typical High $446.68 | Professional | None | $102.33 | $239.88 | $446.68 |
Lucent Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,454.71 | Professional | None | $2,137.96 | $2,137.96 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $213.80 Typical High $354.81 | Professional | None | $33.11 | $213.80 | $354.81 |
Providence Setting Facility Modifier None Typical Low $169.82 Median $3,548.13 Typical High $10,715.19 | Facility | None | $169.82 | $3,548.13 | $10,715.19 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $245.47 Typical High $426.58 | Professional | None | $125.89 | $245.47 | $426.58 |
Sutter Health Plus Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $870.96 | Professional | None | $398.11 | $398.11 | $870.96 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $2,951.21 Typical High $8,317.64 | Facility | None | $1,445.44 | $2,951.21 | $8,317.64 |
United Setting Professional Modifier None Typical Low $104.71 Median $229.09 Typical High $467.74 | Professional | None | $104.71 | $229.09 | $467.74 |
9 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 $60.26 Median $64.57 Typical High $141.25 | Facility | 52 · Reduced service | $60.26 | $64.57 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $25.70 Typical High $56.23 | Facility | 53 · Discontinued | $23.99 | $25.70 | $56.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $19.05 Typical High $42.66 | Facility | 55 · Aftercare only | $17.78 | $19.05 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.88 Typical High $28.18 | Facility | 56 · Pre-op care only | $12.02 | $12.88 | $28.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $104.71 Typical High $141.25 | Professional | 52 · Reduced service | $57.54 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $42.66 Typical High $56.23 | Professional | 53 · Discontinued | $22.91 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $158.49 Typical High $213.80 | Professional | 54 · Surgery only | $87.10 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $31.62 Typical High $42.66 | Professional | 55 · Aftercare only | $17.38 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $21.38 Typical High $28.18 | Professional | 56 · Pre-op care only | $11.48 | $21.38 | $28.18 |
Where California sits
The same service costs 3.4 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· 34th of 51
$245
AK $525VA $155
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.