How much rates vary
Facilitymedian $776 · 10th to 90th $85 to $6,310Professionalmedian $79 · 10th to 90th $49 to $148
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 $100.00 Median $4,570.88 Typical High $15,135.61 | Facility | None | $100.00 | $4,570.88 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $91.20 Typical High $134.90 | Professional | None | $60.26 | $91.20 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $91.20 Typical High $102.33 | Professional | None | $40.74 | $91.20 | $102.33 |
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 $54.95 Median $57.54 Typical High $190.55 | Professional | None | $54.95 | $57.54 | $190.55 |
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 $52.48 Median $77.62 Typical High $123.03 | Professional | None | $52.48 | $77.62 | $123.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $40.74 Median $74.13 Typical High $117.49 | Professional | None | $40.74 | $74.13 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $114.82 Typical High $870.96 | Facility | None | $72.44 | $114.82 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $81.28 Typical High $125.89 | Professional | None | $45.71 | $81.28 | $125.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $44.67 Median $54.95 Typical High $114.82 | Professional | None | $44.67 | $54.95 | $114.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $87.10 Typical High $165.96 | Professional | None | $39.81 | $87.10 | $165.96 |
Lucent Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $104.71 | Professional | None | $63.10 | $63.10 | $104.71 |
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 $70.79 Median $138.04 Typical High $2,570.40 | Facility | None | $70.79 | $138.04 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $45.71 Median $81.28 Typical High $125.89 | Professional | None | $45.71 | $81.28 | $125.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $251.19 | Professional | None | $138.04 | $138.04 | $251.19 |
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 $35.48 Median $69.18 Typical High $131.83 | Professional | None | $35.48 | $69.18 | $131.83 |
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 $31.62 Median $33.88 Typical High $54.95 | Facility | 52 · Reduced service | $31.62 | $33.88 | $54.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.59 Median $13.80 Typical High $21.88 | Facility | 53 · Discontinued | $12.59 | $13.80 | $21.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $46.77 Median $51.29 Typical High $83.18 | Facility | 54 · Surgery only | $46.77 | $51.29 | $83.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.33 Median $10.23 Typical High $16.60 | Facility | 55 · Aftercare only | $9.33 | $10.23 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.92 Typical High $10.96 | Facility | 56 · Pre-op care only | $6.31 | $6.92 | $10.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $33.88 Typical High $48.98 | Professional | 52 · Reduced service | $30.20 | $33.88 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.80 Typical High $19.50 | Professional | 53 · Discontinued | $12.02 | $13.80 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $51.29 Typical High $74.13 | Professional | 54 · Surgery only | $45.71 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.23 Typical High $14.79 | Professional | 55 · Aftercare only | $9.12 | $10.23 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.92 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.03 | $6.92 | $9.77 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $109.65 Typical High $645.65 | Professional | 50 · Both sides | $109.65 | $109.65 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $66.07 Median $109.65 Typical High $144.54 | Professional | 50 · Both sides | $66.07 | $109.65 | $144.54 |
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· 30th of 51
$81.28
AK $204VA $58.88
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.