How much rates vary
Facilitymedian $447 · 10th to 90th $63 to $10,471Professionalmedian $151 · 10th to 90th $60 to $603
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 $169.82 Median $6,760.83 Typical High $18,197.01 | Facility | None | $169.82 | $6,760.83 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $154.88 Typical High $281.84 | Professional | None | $63.10 | $154.88 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $74.13 Typical High $302.00 | Facility | None | $58.88 | $74.13 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $141.25 Typical High $316.23 | Professional | None | $58.88 | $141.25 | $316.23 |
Blue Shield Setting Facility Modifier None Typical Low $213.80 Median $741.31 Typical High $1,318.26 | Facility | None | $213.80 | $741.31 | $1,318.26 |
Blue Shield Setting Professional Modifier None Typical Low $52.48 Median $131.83 Typical High $257.04 | Professional | None | $52.48 | $131.83 | $257.04 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $69.18 Median $173.78 Typical High $302.00 | Professional | None | $69.18 | $173.78 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $154.88 Typical High $323.59 | Professional | None | $67.61 | $154.88 | $323.59 |
Contra Costa Health Setting Professional Modifier None Typical Low $61.66 Median $114.82 Typical High $295.12 | Professional | None | $61.66 | $114.82 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $173.78 Typical High $380.19 | Professional | None | $54.95 | $173.78 | $380.19 |
Lucent Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,698.24 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $162.18 Typical High $275.42 | Professional | None | $33.11 | $162.18 | $275.42 |
Providence Setting Facility Modifier None Typical Low $64.57 Median $169.82 Typical High $302.00 | Facility | None | $64.57 | $169.82 | $302.00 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $154.88 Typical High $323.59 | Professional | None | $67.61 | $154.88 | $323.59 |
Sutter Health Plus Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $676.08 | Professional | None | $223.87 | $223.87 | $676.08 |
United Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
United Setting Professional Modifier None Typical Low $56.23 Median $151.36 Typical High $354.81 | Professional | None | $56.23 | $151.36 | $354.81 |
10 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 $32.36 Median $85.11 Typical High $117.49 | Facility | 52 · Reduced service | $32.36 | $85.11 | $117.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.88 Median $33.88 Typical High $46.77 | Facility | 53 · Discontinued | $12.88 | $33.88 | $46.77 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $47.86 Median $125.89 Typical High $177.83 | Facility | 54 · Surgery only | $47.86 | $125.89 | $177.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $25.12 Typical High $35.48 | Facility | 55 · Aftercare only | $9.55 | $25.12 | $35.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $16.98 Typical High $23.44 | Facility | 56 · Pre-op care only | $6.46 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $74.13 Typical High $97.72 | Professional | 52 · Reduced service | $32.36 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $29.51 Typical High $39.81 | Professional | 53 · Discontinued | $12.88 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $112.20 Typical High $147.91 | Professional | 54 · Surgery only | $47.86 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $22.39 Typical High $29.51 | Professional | 55 · Aftercare only | $9.55 | $22.39 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $14.79 Typical High $19.95 | Professional | 56 · Pre-op care only | $6.46 | $14.79 | $19.95 |
Where California sits
The same service costs 2.9 times more in Washington 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· 42nd of 51
$151
WA $288KY $100
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.