How much rates vary
Facilitymedian $776 · 10th to 90th $81 to $6,310Professionalmedian $89 · 10th to 90th $58 to $186
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 $154.88 Median $5,128.61 Typical High $15,135.61 | Facility | None | $154.88 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $154.88 | Professional | None | $63.10 | $100.00 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $89.13 | Professional | None | $79.43 | $89.13 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $60.26 Typical High $213.80 | Professional | None | $57.54 | $60.26 | $213.80 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $724.44 Typical High $4,570.88 | Facility | None | $100.00 | $724.44 | $4,570.88 |
Blue Shield Setting Professional Modifier None Typical Low $54.95 Median $102.33 Typical High $165.96 | Professional | None | $54.95 | $102.33 | $165.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $48.98 Median $91.20 Typical High $125.89 | Professional | None | $48.98 | $91.20 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $107.15 Typical High $870.96 | Facility | None | $67.61 | $107.15 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $112.20 Typical High $181.97 | Professional | None | $69.18 | $112.20 | $181.97 |
Contra Costa Health Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $123.03 | Professional | None | $52.48 | $69.18 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $95.50 Typical High $208.93 | Professional | None | $48.98 | $95.50 | $208.93 |
Lucent Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $141.25 | Professional | None | $83.18 | $83.18 | $141.25 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $67.61 Median $169.82 Typical High $2,454.71 | Facility | None | $67.61 | $169.82 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $173.78 | Professional | None | $69.18 | $107.15 | $173.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $281.84 | Professional | None | $186.21 | $186.21 | $281.84 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,174.90 Typical High $4,677.35 | Facility | None | $398.11 | $1,174.90 | $4,677.35 |
United Setting Professional Modifier None Typical Low $47.86 Median $81.28 Typical High $154.88 | Professional | None | $47.86 | $81.28 | $154.88 |
11 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 $33.88 Median $36.31 Typical High $75.86 | Facility | 52 · Reduced service | $33.88 | $36.31 | $75.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.49 Median $14.79 Typical High $30.20 | Facility | 53 · Discontinued | $13.49 | $14.79 | $30.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $50.12 Median $54.95 Typical High $114.82 | Facility | 54 · Surgery only | $50.12 | $54.95 | $114.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.00 Median $10.96 Typical High $22.91 | Facility | 55 · Aftercare only | $10.00 | $10.96 | $22.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.41 Typical High $15.14 | Facility | 56 · Pre-op care only | $6.76 | $7.41 | $15.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $41.69 Typical High $66.07 | Professional | 52 · Reduced service | $32.36 | $41.69 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.98 Typical High $26.92 | Professional | 53 · Discontinued | $12.88 | $16.98 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $63.10 Typical High $100.00 | Professional | 54 · Surgery only | $47.86 | $63.10 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $12.59 Typical High $19.95 | Professional | 55 · Aftercare only | $9.77 | $12.59 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.51 Typical High $13.49 | Professional | 56 · Pre-op care only | $6.46 | $8.51 | $13.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $87.10 Median $123.03 Typical High $181.97 | Professional | 50 · Both sides | $87.10 | $123.03 | $181.97 |
Where California sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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· 36th of 51
$93.33
AK $224KY $69.18
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.