How much rates vary
Facilitymedian $1,950 · 10th to 90th $224 to $12,303Professionalmedian $282 · 10th to 90th $145 to $1,023
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 $912.01 Median $8,128.31 Typical High $18,620.87 | Facility | None | $912.01 | $8,128.31 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $398.11 | Professional | None | $169.82 | $263.03 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $10,964.78 Typical High $20,417.38 | Facility | None | $4,786.30 | $10,964.78 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $741.31 Typical High $1,258.93 | Professional | None | $186.21 | $741.31 | $1,258.93 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,041.74 Typical High $9,772.37 | Facility | None | $100.00 | $2,041.74 | $9,772.37 |
Blue Shield Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $660.69 | Professional | None | $177.83 | $251.19 | $660.69 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $134.90 Median $257.04 Typical High $323.59 | Professional | None | $134.90 | $257.04 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $3,235.94 | Facility | None | $194.98 | $316.23 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $229.09 Typical High $776.25 | Professional | None | $125.89 | $229.09 | $776.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $309.03 | Professional | None | $120.23 | $208.93 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $245.47 Typical High $549.54 | Professional | None | $112.20 | $245.47 | $549.54 |
Lucent Health Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Professional | None | $6,760.83 | $6,760.83 | $6,760.83 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $316.23 | Professional | None | $190.55 | $190.55 | $316.23 |
Providence Setting Facility Modifier None Typical Low $199.53 Median $446.68 Typical High $5,370.32 | Facility | None | $199.53 | $446.68 | $5,370.32 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $223.87 Typical High $776.25 | Professional | None | $125.89 | $223.87 | $776.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $707.95 | Professional | None | $398.11 | $398.11 | $707.95 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $102.33 Median $223.87 Typical High $831.76 | Professional | None | $102.33 | $223.87 | $831.76 |
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 $95.50 Median $104.71 Typical High $162.18 | Facility | 52 · Reduced service | $95.50 | $104.71 | $162.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.90 Median $41.69 Typical High $64.57 | Facility | 53 · Discontinued | $38.90 | $41.69 | $64.57 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $144.54 Median $154.88 Typical High $245.47 | Facility | 54 · Surgery only | $144.54 | $154.88 | $245.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $30.90 Typical High $48.98 | Facility | 55 · Aftercare only | $28.84 | $30.90 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.89 Typical High $32.36 | Facility | 56 · Pre-op care only | $19.05 | $20.89 | $32.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $104.71 Typical High $147.91 | Professional | 52 · Reduced service | $87.10 | $104.71 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $41.69 Typical High $58.88 | Professional | 53 · Discontinued | $34.67 | $41.69 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $154.88 Typical High $223.87 | Professional | 54 · Surgery only | $128.82 | $154.88 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $30.90 Typical High $44.67 | Professional | 55 · Aftercare only | $25.70 | $30.90 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $20.89 Typical High $29.51 | Professional | 56 · Pre-op care only | $17.38 | $20.89 | $29.51 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $199.53 Median $338.84 Typical High $1,023.29 | Professional | 50 · Both sides | $199.53 | $338.84 | $1,023.29 |
Where California sits
The same service costs 3.2 times more in Oklahoma than in Texas. 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· 16th of 51
$309
OK $692TX $214
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.