How much rates vary
Facilitymedian $2,188 · 10th to 90th $100 to $6,918Professionalmedian $30 · 10th to 90th $23 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 $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 $23.44 Median $25.70 Typical High $34.67 | Professional | None | $23.44 | $25.70 | $34.67 |
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 $25.70 Median $26.30 Typical High $112.20 | Professional | None | $25.70 | $26.30 | $112.20 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $2,570.40 Typical High $5,754.40 | Facility | None | $95.50 | $2,570.40 | $5,754.40 |
Blue Shield Setting Professional Modifier None Typical Low $21.38 Median $30.20 Typical High $41.69 | Professional | None | $21.38 | $30.20 | $41.69 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $27.54 Median $38.90 Typical High $1,174.90 | Professional | None | $27.54 | $38.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $575.44 Typical High $2,691.53 | Facility | None | $346.74 | $575.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $28.18 Typical High $46.77 | Professional | None | $24.55 | $28.18 | $46.77 |
Contra Costa Health Setting Professional Modifier None Typical Low $25.12 Median $34.67 Typical High $660.69 | Professional | None | $25.12 | $34.67 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.39 Median $31.62 Typical High $69.18 | Professional | None | $22.39 | $31.62 | $69.18 |
Lucent Health Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $794.33 | Professional | None | $512.86 | $794.33 | $794.33 |
Molina Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $40.74 | Professional | None | $24.55 | $24.55 | $40.74 |
Providence Setting Facility Modifier None Typical Low $27.54 Median $346.74 Typical High $2,398.83 | Facility | None | $27.54 | $346.74 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $24.55 Median $28.18 Typical High $46.77 | Professional | None | $24.55 | $28.18 | $46.77 |
Sutter Health Plus Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | None | $91.20 | $91.20 | $97.72 |
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 $21.88 Median $28.18 Typical High $48.98 | Professional | None | $21.88 | $28.18 | $48.98 |
10 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 $11.48 Median $12.59 Typical High $13.49 | Facility | 52 · Reduced service | $11.48 | $12.59 | $13.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.57 Median $5.01 Typical High $5.37 | Facility | 53 · Discontinued | $4.57 | $5.01 | $5.37 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $16.98 Median $19.05 Typical High $20.42 | Facility | 54 · Surgery only | $16.98 | $19.05 | $20.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.39 Median $3.80 Typical High $4.07 | Facility | 55 · Aftercare only | $3.39 | $3.80 | $4.07 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.51 Typical High $2.69 | Facility | 56 · Pre-op care only | $2.29 | $2.51 | $2.69 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.48 Median $12.59 Typical High $13.49 | Professional | 52 · Reduced service | $11.48 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $5.01 Typical High $5.37 | Professional | 53 · Discontinued | $4.57 | $5.01 | $5.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.98 Median $19.05 Typical High $20.42 | Professional | 54 · Surgery only | $16.98 | $19.05 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.80 Typical High $4.07 | Professional | 55 · Aftercare only | $3.39 | $3.80 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.51 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.29 | $2.51 | $2.69 |
Where California sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 43rd of 51
$30.90
AK $110NJ $26.92
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.