How much rates vary
Facilitymedian $4,074 · 10th to 90th $234 to $11,220Professionalmedian $234 · 10th to 90th $115 to $1,778
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 $354.81 Median $5,128.61 Typical High $15,135.61 | Facility | None | $354.81 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $208.93 Typical High $269.15 | Professional | None | $112.20 | $208.93 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $151.36 Median $213.80 Typical High $933.25 | Professional | None | $151.36 | $213.80 | $933.25 |
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 $93.33 Median $190.55 Typical High $371.54 | Professional | None | $93.33 | $190.55 | $371.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $102.33 Median $125.89 Typical High $346.74 | Professional | None | $102.33 | $125.89 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $407.38 | Professional | None | $123.03 | $229.09 | $407.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $371.54 | Professional | None | $112.20 | $158.49 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $234.42 Typical High $436.52 | Professional | None | $100.00 | $234.42 | $436.52 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,778.28 | $2,089.30 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $208.93 Typical High $346.74 | Professional | None | $33.11 | $208.93 | $346.74 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $3,548.13 Typical High $10,715.19 | Facility | None | $162.18 | $3,548.13 | $10,715.19 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $416.87 | Professional | None | $123.03 | $229.09 | $416.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $851.14 | Professional | None | $389.05 | $389.05 | $851.14 |
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 $102.33 Median $223.87 Typical High $446.68 | Professional | None | $102.33 | $223.87 | $446.68 |
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 $57.54 Median $61.66 Typical High $134.90 | Facility | 52 · Reduced service | $57.54 | $61.66 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.91 Median $24.55 Typical High $53.70 | Facility | 53 · Discontinued | $22.91 | $24.55 | $53.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.38 Median $18.62 Typical High $39.81 | Facility | 55 · Aftercare only | $17.38 | $18.62 | $39.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.30 Typical High $26.92 | Facility | 56 · Pre-op care only | $11.48 | $12.30 | $26.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $102.33 Typical High $134.90 | Professional | 52 · Reduced service | $56.23 | $102.33 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $40.74 Typical High $53.70 | Professional | 53 · Discontinued | $22.39 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $151.36 Typical High $199.53 | Professional | 54 · Surgery only | $83.18 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $30.20 Typical High $39.81 | Professional | 55 · Aftercare only | $16.98 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $20.42 Typical High $26.92 | Professional | 56 · Pre-op care only | $11.22 | $20.42 | $26.92 |
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
$234
AK $513VA $151
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.