How much rates vary
Facilitymedian $776 · 10th to 90th $129 to $6,310Professionalmedian $132 · 10th to 90th $95 to $380
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 $331.13 Median $5,128.61 Typical High $15,135.61 | Facility | None | $331.13 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $251.19 | Professional | None | $97.72 | $128.82 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $281.84 Typical High $426.58 | Professional | None | $89.13 | $281.84 | $426.58 |
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 $114.82 Median $117.49 Typical High $380.19 | Professional | None | $114.82 | $117.49 | $380.19 |
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 $77.62 Median $112.20 Typical High $169.82 | Professional | None | $77.62 | $112.20 | $169.82 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $223.87 | Professional | None | $95.50 | $138.04 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $181.97 Typical High $870.96 | Facility | None | $100.00 | $181.97 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $223.87 | Professional | None | $107.15 | $141.25 | $223.87 |
Contra Costa Health Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $218.78 | Professional | None | $91.20 | $117.49 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $331.13 | Professional | None | $97.72 | $169.82 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,096.48 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $218.78 | Professional | None | $131.83 | $131.83 | $218.78 |
Providence Setting Facility Modifier None Typical Low $102.33 Median $177.83 Typical High $870.96 | Facility | None | $102.33 | $177.83 | $870.96 |
Providence Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $218.78 | Professional | None | $107.15 | $141.25 | $218.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $478.63 | Professional | None | $346.74 | $346.74 | $478.63 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $4,677.35 | Facility | None | $398.11 | $1,202.26 | $4,677.35 |
United Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $245.47 | Professional | None | $87.10 | $134.90 | $245.47 |
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 $48.98 Median $53.70 Typical High $72.44 | Facility | 52 · Reduced service | $48.98 | $53.70 | $72.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.50 Median $21.38 Typical High $28.84 | Facility | 53 · Discontinued | $19.50 | $21.38 | $28.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $16.22 Typical High $21.88 | Facility | 55 · Aftercare only | $14.79 | $16.22 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.72 Typical High $14.45 | Facility | 56 · Pre-op care only | $9.77 | $10.72 | $14.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $58.88 Typical High $72.44 | Professional | 52 · Reduced service | $47.86 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $23.99 Typical High $28.84 | Professional | 53 · Discontinued | $19.05 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $89.13 Typical High $109.65 | Professional | 54 · Surgery only | $72.44 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $17.78 Typical High $21.88 | Professional | 55 · Aftercare only | $14.45 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.75 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.55 | $11.75 | $14.45 |
Where California sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 45th of 51
$138
AK $437FL $123
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.