How much rates vary
Facilitymedian $2,239 · 10th to 90th $151 to $7,943Professionalmedian $224 · 10th to 90th $148 to $1,288
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 $1,905.46 Median $6,165.95 Typical High $15,848.93 | Facility | None | $1,905.46 | $6,165.95 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $186.21 | Professional | None | $162.18 | $173.78 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $10,000.00 | Facility | None | $2,137.96 | $4,786.30 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $501.19 | Professional | None | $177.83 | $245.47 | $501.19 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $2,454.71 Typical High $6,760.83 | Facility | None | $95.50 | $2,454.71 | $6,760.83 |
Blue Shield Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $288.40 | Professional | None | $141.25 | $208.93 | $288.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $186.21 | Professional | None | $95.50 | $151.36 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $2,691.53 | Facility | None | $446.68 | $741.31 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $281.84 | Professional | None | $141.25 | $190.55 | $281.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $81.28 Median $165.96 Typical High $181.97 | Professional | None | $81.28 | $165.96 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $446.68 | Professional | None | $147.91 | $186.21 | $446.68 |
Lucent Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,348.96 | Professional | None | $1,288.25 | $1,288.25 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
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 $190.55 Median $645.65 Typical High $2,511.89 | Facility | None | $190.55 | $645.65 | $2,511.89 |
Providence Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $281.84 | Professional | None | $141.25 | $190.55 | $281.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
United Setting Facility Modifier None Typical Low $123.03 Median $501.19 Typical High $3,090.30 | Facility | None | $123.03 | $501.19 | $3,090.30 |
United Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $288.40 | Professional | None | $138.04 | $181.97 | $288.40 |
5 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 Professional Modifier 52 · Reduced service Typical Low $81.28 Median $87.10 Typical High $93.33 | Professional | 52 · Reduced service | $81.28 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $34.67 Typical High $37.15 | Professional | 53 · Discontinued | $32.36 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $131.83 Typical High $141.25 | Professional | 54 · Surgery only | $120.23 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.30 Typical High $28.18 | Professional | 55 · Aftercare only | $23.99 | $26.30 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.38 Typical High $18.62 | Professional | 56 · Pre-op care only | $16.22 | $17.38 | $18.62 |
Where California sits
The same service costs 4.5 times more in Alaska than in New York. 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· 23rd of 51
$245
AK $724NY $162
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.