How much rates vary
Facilitymedian $575 · 10th to 90th $76 to $6,310Professionalmedian $91 · 10th to 90th $48 to $316
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 $67.61 Median $6,456.54 Typical High $18,197.01 | Facility | None | $67.61 | $6,456.54 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $91.20 Typical High $154.88 | Professional | None | $47.86 | $91.20 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $77.62 Typical High $120.23 | Professional | None | $72.44 | $77.62 | $120.23 |
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 $50.12 Median $54.95 Typical High $316.23 | Professional | None | $50.12 | $54.95 | $316.23 |
Blue Shield Setting Facility Modifier None Typical Low $89.13 Median $416.87 Typical High $1,479.11 | Facility | None | $89.13 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $43.65 Median $100.00 Typical High $223.87 | Professional | None | $43.65 | $100.00 | $223.87 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $38.02 Median $52.48 Typical High $117.49 | Professional | None | $38.02 | $52.48 | $117.49 |
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 $53.70 Median $100.00 Typical High $173.78 | Professional | None | $53.70 | $100.00 | $173.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $34.67 Median $52.48 Typical High $114.82 | Professional | None | $34.67 | $52.48 | $114.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $91.20 Typical High $186.21 | Professional | None | $43.65 | $91.20 | $186.21 |
Lucent Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $707.95 | Professional | None | $676.08 | $676.08 | $707.95 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $112.20 | Professional | None | $67.61 | $67.61 | $112.20 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $676.08 | Facility | None | $50.12 | $75.86 | $676.08 |
Providence Setting Professional Modifier None Typical Low $53.70 Median $100.00 Typical High $177.83 | Professional | None | $53.70 | $100.00 | $177.83 |
Sutter Health Plus Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $269.15 | Professional | None | $151.36 | $151.36 | $269.15 |
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 $40.74 Median $79.43 Typical High $190.55 | Professional | None | $40.74 | $79.43 | $190.55 |
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 $26.30 Median $28.18 Typical High $66.07 | Facility | 52 · Reduced service | $26.30 | $28.18 | $66.07 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.72 Median $11.22 Typical High $26.30 | Facility | 53 · Discontinued | $10.72 | $11.22 | $26.30 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $39.81 Median $42.66 Typical High $100.00 | Facility | 54 · Surgery only | $39.81 | $42.66 | $100.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.94 Median $8.51 Typical High $19.95 | Facility | 55 · Aftercare only | $7.94 | $8.51 | $19.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.62 Typical High $13.18 | Facility | 56 · Pre-op care only | $5.37 | $5.62 | $13.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $35.48 Typical High $60.26 | Professional | 52 · Reduced service | $23.99 | $35.48 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $14.13 Typical High $23.99 | Professional | 53 · Discontinued | $9.55 | $14.13 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $52.48 Typical High $89.13 | Professional | 54 · Surgery only | $36.31 | $52.48 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $10.47 Typical High $17.78 | Professional | 55 · Aftercare only | $7.24 | $10.47 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.08 Typical High $12.02 | Professional | 56 · Pre-op care only | $4.79 | $7.08 | $12.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $67.61 Median $112.20 Typical High $288.40 | Professional | 50 · Both sides | $67.61 | $112.20 | $288.40 |
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· 18th of 51
$105
AK $214KY $64.57
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.