How much rates vary
Facilitymedian $407 · 10th to 90th $65 to $10,715Professionalmedian $129 · 10th to 90th $60 to $724
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 $151.36 Median $7,079.46 Typical High $18,197.01 | Facility | None | $151.36 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $123.03 Typical High $190.55 | Professional | None | $64.57 | $123.03 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $74.13 Typical High $309.03 | Facility | None | $58.88 | $74.13 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $125.89 Typical High $275.42 | Professional | None | $60.26 | $125.89 | $275.42 |
Blue Shield Setting Facility Modifier None Typical Low $194.98 Median $660.69 Typical High $1,202.26 | Facility | None | $194.98 | $660.69 | $1,202.26 |
Blue Shield Setting Professional Modifier None Typical Low $51.29 Median $114.82 Typical High $218.78 | Professional | None | $51.29 | $114.82 | $218.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $223.87 | Professional | None | $69.18 | $128.82 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $138.04 Typical High $245.47 | Professional | None | $67.61 | $138.04 | $245.47 |
Contra Costa Health Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $218.78 | Professional | None | $61.66 | $85.11 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $147.91 Typical High $295.12 | Professional | None | $54.95 | $147.91 | $295.12 |
Lucent Health Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $933.25 | $1,288.25 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $123.03 Typical High $204.17 | Professional | None | $33.11 | $123.03 | $204.17 |
Providence Setting Facility Modifier None Typical Low $64.57 Median $151.36 Typical High $281.84 | Facility | None | $64.57 | $151.36 | $281.84 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $141.25 Typical High $251.19 | Professional | None | $67.61 | $141.25 | $251.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $501.19 | Professional | None | $218.78 | $218.78 | $501.19 |
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 $123.03 Typical High $263.03 | Professional | None | $56.23 | $123.03 | $263.03 |
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 $35.48 Typical High $87.10 | Facility | 52 · Reduced service | $32.36 | $35.48 | $87.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.88 Median $14.45 Typical High $34.67 | Facility | 53 · Discontinued | $12.88 | $14.45 | $34.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $48.98 Median $53.70 Typical High $131.83 | Facility | 54 · Surgery only | $48.98 | $53.70 | $131.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.77 Median $10.72 Typical High $26.30 | Facility | 55 · Aftercare only | $9.77 | $10.72 | $26.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.24 Typical High $17.38 | Facility | 56 · Pre-op care only | $6.46 | $7.24 | $17.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $56.23 Typical High $81.28 | Professional | 52 · Reduced service | $32.36 | $56.23 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $22.91 Typical High $32.36 | Professional | 53 · Discontinued | $12.88 | $22.91 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $85.11 Typical High $120.23 | Professional | 54 · Surgery only | $48.98 | $85.11 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $16.98 Typical High $23.99 | Professional | 55 · Aftercare only | $9.77 | $16.98 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $11.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $6.46 | $11.22 | $16.22 |
Where California sits
The same service costs 3.5 times more in Alaska 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· 35th of 51
$132
AK $263KY $75.86
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.