How much rates vary
Facilitymedian $617 · 10th to 90th $89 to $6,310Professionalmedian $110 · 10th to 90th $87 to $398
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 $7,079.46 Typical High $18,197.01 | Facility | None | $100.00 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $141.25 | Professional | None | $89.13 | $100.00 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $109.65 | Professional | None | $87.10 | $87.10 | $109.65 |
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 $75.86 Median $97.72 Typical High $323.59 | Professional | None | $75.86 | $97.72 | $323.59 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $1,479.11 | Facility | None | $97.72 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $154.88 | Professional | None | $77.62 | $109.65 | $154.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $245.47 | Professional | None | $114.82 | $162.18 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $676.08 | Facility | None | $50.12 | $61.66 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $194.98 | Professional | None | $91.20 | $109.65 | $194.98 |
Contra Costa Health Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $173.78 | Professional | None | $102.33 | $138.04 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $281.84 | Professional | None | $89.13 | $128.82 | $281.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,122.02 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,122.02 | $2,290.87 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $162.18 | Professional | None | $97.72 | $97.72 | $162.18 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $117.49 Typical High $676.08 | Facility | None | $50.12 | $117.49 | $676.08 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $181.97 | Professional | None | $91.20 | $109.65 | $181.97 |
Sutter Health Plus Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | None | $338.84 | $338.84 | $380.19 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,090.30 | Facility | None | $123.03 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $194.98 | Professional | None | $81.28 | $107.15 | $194.98 |
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 $44.67 Median $47.86 Typical High $53.70 | Facility | 52 · Reduced service | $44.67 | $47.86 | $53.70 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.78 Median $19.05 Typical High $21.38 | Facility | 53 · Discontinued | $17.78 | $19.05 | $21.38 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $66.07 Median $72.44 Typical High $81.28 | Facility | 54 · Surgery only | $66.07 | $72.44 | $81.28 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $14.45 Typical High $16.22 | Facility | 55 · Aftercare only | $13.49 | $14.45 | $16.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.55 Typical High $10.72 | Facility | 56 · Pre-op care only | $8.91 | $9.55 | $10.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $47.86 Typical High $53.70 | Professional | 52 · Reduced service | $44.67 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $19.05 Typical High $21.38 | Professional | 53 · Discontinued | $17.78 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $72.44 Typical High $81.28 | Professional | 54 · Surgery only | $66.07 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.45 Typical High $16.22 | Professional | 55 · Aftercare only | $13.49 | $14.45 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.55 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.91 | $9.55 | $10.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $147.91 Median $173.78 Typical High $239.88 | Professional | 50 · Both sides | $147.91 | $173.78 | $239.88 |
Where California sits
The same service costs 4.5 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· 40th of 51
$115
AK $407FL $91.20
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.