How much rates vary
Facilitymedian $589 · 10th to 90th $79 to $7,413Professionalmedian $107 · 10th to 90th $55 to $295
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 $134.90 Median $7,079.46 Typical High $18,197.01 | Facility | None | $134.90 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $87.10 Typical High $162.18 | Professional | None | $52.48 | $87.10 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $77.62 | Professional | None | $74.13 | $74.13 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $120.23 Typical High $239.88 | Professional | None | $54.95 | $120.23 | $239.88 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $416.87 Typical High $1,479.11 | Facility | None | $95.50 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $51.29 Median $104.71 Typical High $234.42 | Professional | None | $51.29 | $104.71 | $234.42 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $45.71 Median $69.18 Typical High $109.65 | Professional | None | $45.71 | $69.18 | $109.65 |
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 $58.88 Median $102.33 Typical High $181.97 | Professional | None | $58.88 | $102.33 | $181.97 |
Contra Costa Health Setting Professional Modifier None Typical Low $41.69 Median $54.95 Typical High $107.15 | Professional | None | $41.69 | $54.95 | $107.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $87.10 Typical High $190.55 | Professional | None | $45.71 | $87.10 | $190.55 |
Lucent Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $109.65 | Professional | None | $66.07 | $66.07 | $109.65 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $81.28 Typical High $676.08 | Facility | None | $50.12 | $81.28 | $676.08 |
Providence Setting Professional Modifier None Typical Low $58.88 Median $100.00 Typical High $186.21 | Professional | None | $58.88 | $100.00 | $186.21 |
Sutter Health Plus Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $263.03 | Professional | None | $165.96 | $165.96 | $263.03 |
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 $43.65 Median $81.28 Typical High $199.53 | Professional | None | $43.65 | $81.28 | $199.53 |
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 $29.51 Median $30.90 Typical High $74.13 | Facility | 52 · Reduced service | $29.51 | $30.90 | $74.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.75 Median $12.30 Typical High $30.20 | Facility | 53 · Discontinued | $11.75 | $12.30 | $30.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $43.65 Median $46.77 Typical High $112.20 | Facility | 54 · Surgery only | $43.65 | $46.77 | $112.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.71 Median $9.33 Typical High $22.39 | Facility | 55 · Aftercare only | $8.71 | $9.33 | $22.39 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.17 Typical High $14.79 | Facility | 56 · Pre-op care only | $5.89 | $6.17 | $14.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $34.67 Typical High $67.61 | Professional | 52 · Reduced service | $26.30 | $34.67 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $13.80 Typical High $26.92 | Professional | 53 · Discontinued | $10.72 | $13.80 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $52.48 Typical High $102.33 | Professional | 54 · Surgery only | $39.81 | $52.48 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.47 Typical High $20.42 | Professional | 55 · Aftercare only | $7.94 | $10.47 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.92 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.25 | $6.92 | $13.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $81.28 Median $123.03 Typical High $239.88 | Professional | 50 · Both sides | $81.28 | $123.03 | $239.88 |
Where California sits
The same service costs 3.2 times more in Wisconsin 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· 12th of 51
$120
WI $229KY $72.44
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.