How much rates vary
Facilitymedian $4,786 · 10th to 90th $263 to $14,454Professionalmedian $162 · 10th to 90th $72 to $1,698
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 $190.55 Median $7,079.46 Typical High $18,197.01 | Facility | None | $190.55 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $173.78 Typical High $407.38 | Professional | None | $81.28 | $173.78 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,456.54 Typical High $14,125.38 | Facility | None | $2,884.03 | $6,456.54 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $158.49 Typical High $426.58 | Professional | None | $72.44 | $158.49 | $426.58 |
Blue Shield Setting Facility Modifier None Typical Low $229.09 Median $1,047.13 Typical High $1,621.81 | Facility | None | $229.09 | $1,047.13 | $1,621.81 |
Blue Shield Setting Professional Modifier None Typical Low $56.23 Median $131.83 Typical High $251.19 | Professional | None | $56.23 | $131.83 | $251.19 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $77.62 Median $154.88 Typical High $1,122.02 | Professional | None | $77.62 | $154.88 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $190.55 Typical High $851.14 | Professional | None | $91.20 | $190.55 | $851.14 |
Contra Costa Health Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $1,096.48 | Professional | None | $79.43 | $93.33 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $630.96 Typical High $1,174.90 | Professional | None | $77.62 | $630.96 | $1,174.90 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $6,165.95 Typical High $6,165.95 | Professional | None | $4,677.35 | $6,165.95 | $6,165.95 |
Molina Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $933.25 | Professional | None | $562.34 | $562.34 | $933.25 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $81.28 Median $181.97 Typical High $457.09 | Facility | None | $81.28 | $181.97 | $457.09 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $190.55 Typical High $851.14 | Professional | None | $91.20 | $190.55 | $851.14 |
Sutter Health Plus Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $1,698.24 | Professional | None | $302.00 | $302.00 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $6,165.95 Typical High $18,620.87 | Facility | None | $1,995.26 | $6,165.95 | $18,620.87 |
United Setting Professional Modifier None Typical Low $74.13 Median $239.88 Typical High $977.24 | Professional | None | $74.13 | $239.88 | $977.24 |
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 $39.81 Median $44.67 Typical High $109.65 | Facility | 52 · Reduced service | $39.81 | $44.67 | $109.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $17.78 Typical High $44.67 | Facility | 53 · Discontinued | $16.22 | $17.78 | $44.67 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $13.49 Typical High $33.11 | Facility | 55 · Aftercare only | $12.02 | $13.49 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.91 Typical High $21.88 | Facility | 56 · Pre-op care only | $7.94 | $8.91 | $21.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $79.43 Typical High $141.25 | Professional | 52 · Reduced service | $39.81 | $79.43 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $31.62 Typical High $56.23 | Professional | 53 · Discontinued | $16.22 | $31.62 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $117.49 Typical High $234.42 | Professional | 54 · Surgery only | $60.26 | $117.49 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $23.44 Typical High $42.66 | Professional | 55 · Aftercare only | $12.02 | $23.44 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $17.38 Typical High $28.18 | Professional | 56 · Pre-op care only | $7.94 | $17.38 | $28.18 |
Where California sits
The same service costs 9.5 times more in Washington than in Washington, DC. 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· 44th of 51
$170
WA $933DC $97.72
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.