How much rates vary
Facilitymedian $891 · 10th to 90th $91 to $6,166Professionalmedian $89 · 10th to 90th $43 to $324
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 $41.69 Median $87.10 Typical High $147.91 | Professional | None | $41.69 | $87.10 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $89.13 Typical High $562.34 | Professional | None | $41.69 | $89.13 | $562.34 |
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 $43.65 Median $51.29 Typical High $380.19 | Professional | None | $43.65 | $51.29 | $380.19 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $1,288.25 Typical High $4,786.30 | Facility | None | $97.72 | $1,288.25 | $4,786.30 |
Blue Shield Setting Professional Modifier None Typical Low $38.02 Median $79.43 Typical High $186.21 | Professional | None | $38.02 | $79.43 | $186.21 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $38.90 Median $56.23 Typical High $134.90 | Professional | None | $38.90 | $56.23 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $138.04 Typical High $758.58 | Facility | None | $85.11 | $138.04 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $95.50 Typical High $181.97 | Professional | None | $47.86 | $95.50 | $181.97 |
Contra Costa Health Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $131.83 | Professional | None | $39.81 | $47.86 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $97.72 Typical High $186.21 | Professional | None | $38.90 | $97.72 | $186.21 |
Lucent Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $794.33 | Professional | None | $676.08 | $676.08 | $794.33 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $131.83 | Professional | None | $79.43 | $79.43 | $131.83 |
Providence Setting Facility Modifier None Typical Low $77.62 Median $154.88 Typical High $2,570.40 | Facility | None | $77.62 | $154.88 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $47.86 Median $95.50 Typical High $181.97 | Professional | None | $47.86 | $95.50 | $181.97 |
Sutter Health Plus Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $323.59 | Professional | None | $154.88 | $154.88 | $323.59 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $39.81 Median $87.10 Typical High $208.93 | Professional | None | $39.81 | $87.10 | $208.93 |
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 $22.91 Median $23.44 Typical High $54.95 | Facility | 52 · Reduced service | $22.91 | $23.44 | $54.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.12 Median $9.33 Typical High $21.88 | Facility | 53 · Discontinued | $9.12 | $9.33 | $21.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $33.88 Median $35.48 Typical High $81.28 | Facility | 54 · Surgery only | $33.88 | $35.48 | $81.28 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.76 Median $7.08 Typical High $16.22 | Facility | 55 · Aftercare only | $6.76 | $7.08 | $16.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.68 Typical High $10.96 | Facility | 56 · Pre-op care only | $4.57 | $4.68 | $10.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $41.69 Typical High $50.12 | Professional | 52 · Reduced service | $21.38 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $16.98 Typical High $19.95 | Professional | 53 · Discontinued | $8.51 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $63.10 Typical High $74.13 | Professional | 54 · Surgery only | $31.62 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $12.59 Typical High $14.79 | Professional | 55 · Aftercare only | $6.31 | $12.59 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $8.51 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.27 | $8.51 | $10.00 |
Where California sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 21st of 51
$100
AK $204KY $61.66
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.