How much rates vary
Facilitymedian $490 · 10th to 90th $58 to $5,370Professionalmedian $20 · 10th to 90th $12 to $95
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 $776.25 Median $5,128.61 Typical High $15,135.61 | Facility | None | $776.25 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $14.45 Typical High $30.20 | Professional | None | $11.48 | $14.45 | $30.20 |
Ambetter Setting Professional Modifier None Typical Low $15.85 Median $17.78 Typical High $20.89 | Professional | None | $15.85 | $17.78 | $20.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.42 Median $26.92 Typical High $3,890.45 | Facility | None | $20.42 | $26.92 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $21.88 Typical High $58.88 | Professional | None | $20.42 | $21.88 | $58.88 |
Blue Shield Setting Facility Modifier None Typical Low $89.13 Median $407.38 Typical High $1,513.56 | Facility | None | $89.13 | $407.38 | $1,513.56 |
Blue Shield Setting Professional Modifier None Typical Low $10.47 Median $14.79 Typical High $37.15 | Professional | None | $10.47 | $14.79 | $37.15 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $12.02 Median $19.50 Typical High $26.92 | Professional | None | $12.02 | $19.50 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $758.58 Typical High $5,623.41 | Facility | None | $56.23 | $758.58 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $16.22 Typical High $41.69 | Professional | None | $12.88 | $16.22 | $41.69 |
Contra Costa Health Setting Professional Modifier None Typical Low $10.96 Median $17.38 Typical High $28.18 | Professional | None | $10.96 | $17.38 | $28.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $18.62 Median $23.99 Typical High $52.48 | Professional | None | $18.62 | $23.99 | $52.48 |
Lucent Health Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $147.91 | Professional | None | $112.20 | $147.91 | $147.91 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Providence Setting Facility Modifier None Typical Low $20.89 Median $660.69 Typical High $5,623.41 | Facility | None | $20.89 | $660.69 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $12.30 Median $15.85 Typical High $42.66 | Professional | None | $12.30 | $15.85 | $42.66 |
Sutter Health Plus Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
United Setting Facility Modifier None Typical Low $120.23 Median $489.78 Typical High $3,090.30 | Facility | None | $120.23 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $10.72 Median $15.85 Typical High $46.77 | Professional | None | $10.72 | $15.85 | $46.77 |
7 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 $5.75 Median $6.31 Typical High $7.24 | Professional | 52 · Reduced service | $5.75 | $6.31 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.51 Typical High $2.88 | Professional | 53 · Discontinued | $2.29 | $2.51 | $2.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.51 Median $9.33 Typical High $10.72 | Professional | 54 · Surgery only | $8.51 | $9.33 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.86 Typical High $2.14 | Professional | 55 · Aftercare only | $1.74 | $1.86 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.26 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.15 | $1.26 | $1.45 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $25.70 Median $26.30 Typical High $141.25 | Professional | 50 · Both sides | $25.70 | $26.30 | $141.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $19.50 Median $25.70 Typical High $51.29 | Professional | 50 · Both sides | $19.50 | $25.70 | $51.29 |
Where California sits
The same service costs 7.4 times more in Kansas 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· 29th of 51
$21.38
KS $95.50KY $12.88
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.