How much rates vary
Facilitymedian $776 · 10th to 90th $76 to $6,310Professionalmedian $95 · 10th to 90th $60 to $263
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 $60.26 Median $97.72 Typical High $158.49 | Professional | None | $60.26 | $97.72 | $158.49 |
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 $66.07 Median $69.18 Typical High $204.17 | Professional | None | $66.07 | $69.18 | $204.17 |
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 $63.10 Median $109.65 Typical High $173.78 | Professional | None | $63.10 | $109.65 | $173.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $38.90 Median $87.10 Typical High $123.03 | Professional | None | $38.90 | $87.10 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $100.00 Typical High $870.96 | Facility | None | $63.10 | $100.00 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $186.21 | Professional | None | $79.43 | $117.49 | $186.21 |
Contra Costa Health Setting Professional Modifier None Typical Low $42.66 Median $72.44 Typical High $102.33 | Professional | None | $42.66 | $72.44 | $102.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $79.43 Typical High $181.97 | Professional | None | $39.81 | $79.43 | $181.97 |
Lucent Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $131.83 | Professional | None | $79.43 | $79.43 | $131.83 |
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 $63.10 Median $154.88 Typical High $2,454.71 | Facility | None | $63.10 | $154.88 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $173.78 | Professional | None | $79.43 | $114.82 | $173.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $239.88 | Professional | None | $141.25 | $141.25 | $239.88 |
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 $36.31 Median $77.62 Typical High $162.18 | Professional | None | $36.31 | $77.62 | $162.18 |
12 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 $38.02 Median $40.74 Typical High $75.86 | Facility | 52 · Reduced service | $38.02 | $40.74 | $75.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.14 Median $16.22 Typical High $30.20 | Facility | 53 · Discontinued | $15.14 | $16.22 | $30.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $56.23 Median $61.66 Typical High $114.82 | Facility | 54 · Surgery only | $56.23 | $61.66 | $114.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $12.30 Typical High $22.91 | Facility | 55 · Aftercare only | $11.22 | $12.30 | $22.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.13 Typical High $15.14 | Facility | 56 · Pre-op care only | $7.59 | $8.13 | $15.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $40.74 Typical High $67.61 | Professional | 52 · Reduced service | $36.31 | $40.74 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $16.22 Typical High $26.92 | Professional | 53 · Discontinued | $14.45 | $16.22 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $61.66 Typical High $102.33 | Professional | 54 · Surgery only | $53.70 | $61.66 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.30 Typical High $20.42 | Professional | 55 · Aftercare only | $10.72 | $12.30 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.13 Typical High $13.49 | Professional | 56 · Pre-op care only | $7.24 | $8.13 | $13.49 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 59 · Distinct service | $72.44 | $72.44 | $72.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $72.44 Median $123.03 Typical High $229.09 | Professional | 50 · Both sides | $72.44 | $123.03 | $229.09 |
Where California sits
The same service costs 3.2 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· 25th of 51
$100
AK $191VA $60.26
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.