How much rates vary
Facilitymedian $4,467 · 10th to 90th $813 to $12,589Professionalmedian $2,884 · 10th to 90th $219 to $9,120
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 $1,949.84 Median $5,888.44 Typical High $15,848.93 | Facility | None | $1,949.84 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $2,818.38 Typical High $4,677.35 | Professional | None | $213.80 | $2,818.38 | $4,677.35 |
Ambetter Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $6,606.93 Typical High $13,489.63 | Facility | None | $2,951.21 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $3,548.13 Typical High $8,912.51 | Professional | None | $245.47 | $3,548.13 | $8,912.51 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $1,698.24 Typical High $4,365.16 | Facility | None | $95.50 | $1,698.24 | $4,365.16 |
Blue Shield Setting Professional Modifier None Typical Low $173.78 Median $1,778.28 Typical High $5,128.61 | Professional | None | $173.78 | $1,778.28 | $5,128.61 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $208.93 Median $3,388.44 Typical High $4,365.16 | Professional | None | $208.93 | $3,388.44 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $6,165.95 Typical High $10,715.19 | Facility | None | $758.58 | $6,165.95 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $3,162.28 Typical High $5,623.41 | Professional | None | $239.88 | $3,162.28 | $5,623.41 |
Contra Costa Health Setting Professional Modifier None Typical Low $223.87 Median $2,951.21 Typical High $4,365.16 | Professional | None | $223.87 | $2,951.21 | $4,365.16 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $2,630.27 Typical High $5,495.41 | Professional | None | $208.93 | $2,630.27 | $5,495.41 |
Lucent Health Setting Professional Modifier None Typical Low $19,054.61 Median $22,908.68 Typical High $22,908.68 | Professional | None | $19,054.61 | $22,908.68 | $22,908.68 |
Molina Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,715.35 | Professional | None | $2,238.72 | $2,238.72 | $3,715.35 |
Providence Setting Facility Modifier None Typical Low $676.08 Median $6,165.95 Typical High $12,882.50 | Facility | None | $676.08 | $6,165.95 | $12,882.50 |
Providence Setting Professional Modifier None Typical Low $239.88 Median $3,162.28 Typical High $5,623.41 | Professional | None | $239.88 | $3,162.28 | $5,623.41 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,754.40 | $17,378.01 |
United Setting Professional Modifier None Typical Low $213.80 Median $2,754.23 Typical High $6,456.54 | Professional | None | $213.80 | $2,754.23 | $6,456.54 |
9 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 $109.65 Median $112.20 Typical High $1,737.80 | Facility | 52 · Reduced service | $109.65 | $112.20 | $1,737.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $43.65 Median $44.67 Typical High $691.83 | Facility | 53 · Discontinued | $43.65 | $44.67 | $691.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $512.86 | Facility | 55 · Aftercare only | $33.11 | $33.11 | $512.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.88 Median $22.39 Typical High $346.74 | Facility | 56 · Pre-op care only | $21.88 | $22.39 | $346.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $1,122.02 Typical High $1,584.89 | Professional | 52 · Reduced service | $109.65 | $1,122.02 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $457.09 Typical High $630.96 | Professional | 53 · Discontinued | $43.65 | $457.09 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $1,698.24 Typical High $2,344.23 | Professional | 54 · Surgery only | $162.18 | $1,698.24 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $338.84 Typical High $467.74 | Professional | 55 · Aftercare only | $33.11 | $338.84 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $229.09 Typical High $316.23 | Professional | 56 · Pre-op care only | $21.88 | $229.09 | $316.23 |
Where California sits
The same service costs 11.2 times more in Alaska than in Nebraska. 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· 15th of 51
$3,020
AK $5,248NE $468
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.