How much rates vary
Facilitymedian $2,951 · 10th to 90th $93 to $10,233Professionalmedian $162 · 10th to 90th $65 to $537
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 $478.63 Median $5,128.61 Typical High $15,135.61 | Facility | None | $478.63 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $162.18 Typical High $257.04 | Professional | None | $63.10 | $162.18 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $162.18 Typical High $398.11 | Professional | None | $64.57 | $162.18 | $398.11 |
Blue Shield Setting Facility Modifier None Typical Low $63.10 Median $186.21 Typical High $346.74 | Facility | None | $63.10 | $186.21 | $346.74 |
Blue Shield Setting Professional Modifier None Typical Low $54.95 Median $120.23 Typical High $208.93 | Professional | None | $54.95 | $120.23 | $208.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $50.12 Median $173.78 Typical High $223.87 | Professional | None | $50.12 | $173.78 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $251.19 Typical High $758.58 | Facility | None | $208.93 | $251.19 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $154.88 Typical High $257.04 | Professional | None | $67.61 | $154.88 | $257.04 |
Contra Costa Health Setting Professional Modifier None Typical Low $54.95 Median $131.83 Typical High $218.78 | Professional | None | $54.95 | $131.83 | $218.78 |
HealthNet Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $50.12 Median $154.88 Typical High $309.03 | Professional | None | $50.12 | $154.88 | $309.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,258.93 | Professional | None | $1,230.27 | $1,230.27 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $234.42 | Professional | None | $141.25 | $141.25 | $234.42 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $177.83 Typical High $302.00 | Facility | None | $58.88 | $177.83 | $302.00 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $154.88 Typical High $251.19 | Professional | None | $67.61 | $154.88 | $251.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $602.56 | Professional | None | $245.47 | $245.47 | $602.56 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $501.19 | Facility | None | $331.13 | $331.13 | $501.19 |
United Setting Professional Modifier None Typical Low $57.54 Median $134.90 Typical High $309.03 | Professional | None | $57.54 | $134.90 | $309.03 |
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 $104.71 | Facility | 52 · Reduced service | $32.36 | $35.48 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.88 Median $14.45 Typical High $41.69 | Facility | 53 · Discontinued | $12.88 | $14.45 | $41.69 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $47.86 Median $53.70 Typical High $154.88 | Facility | 54 · Surgery only | $47.86 | $53.70 | $154.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $10.72 Typical High $30.90 | Facility | 55 · Aftercare only | $9.55 | $10.72 | $30.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.24 Typical High $20.89 | Facility | 56 · Pre-op care only | $6.46 | $7.24 | $20.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $64.57 Typical High $95.50 | Professional | 52 · Reduced service | $32.36 | $64.57 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $26.30 Typical High $38.02 | Professional | 53 · Discontinued | $12.88 | $26.30 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $97.72 Typical High $141.25 | Professional | 54 · Surgery only | $47.86 | $97.72 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $19.50 Typical High $28.18 | Professional | 55 · Aftercare only | $9.55 | $19.50 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $10.47 Typical High $19.05 | Professional | 56 · Pre-op care only | $6.46 | $10.47 | $19.05 |
Where California sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 21st of 51
$162
AK $288MD $83.18
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.