How much rates vary
Facilitymedian $200 · 10th to 90th $74 to $631Professionalmedian $68 · 10th to 90th $46 to $182
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 $60.26 Median $128.82 Typical High $398.11 | Facility | None | $60.26 | $128.82 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $74.13 Typical High $158.49 | Professional | None | $60.26 | $74.13 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $70.79 Typical High $114.82 | Professional | None | $38.02 | $70.79 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $204.17 Typical High $562.34 | Facility | None | $141.25 | $204.17 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $67.61 Typical High $181.97 | Professional | None | $45.71 | $67.61 | $181.97 |
Blue Shield Setting Facility Modifier None Typical Low $104.71 Median $457.09 Typical High $870.96 | Facility | None | $104.71 | $457.09 | $870.96 |
Blue Shield Setting Professional Modifier None Typical Low $36.31 Median $52.48 Typical High $79.43 | Professional | None | $36.31 | $52.48 | $79.43 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $102.33 | Professional | None | $72.44 | $91.20 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $173.78 Typical High $346.74 | Facility | None | $67.61 | $173.78 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $147.91 | Professional | None | $60.26 | $60.26 | $147.91 |
Contra Costa Health Setting Professional Modifier None Typical Low $64.57 Median $125.89 Typical High $125.89 | Professional | None | $64.57 | $125.89 | $125.89 |
HealthNet Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $309.03 | Professional | None | $97.72 | $114.82 | $309.03 |
Lucent Health Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $223.87 | Professional | None | $97.72 | $109.65 | $223.87 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Providence Setting Facility Modifier None Typical Low $70.79 Median $125.89 Typical High $302.00 | Facility | None | $70.79 | $125.89 | $302.00 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $114.82 | Professional | None | $60.26 | $60.26 | $114.82 |
Sutter Health Plus Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $114.82 | Facility | None | $47.86 | $47.86 | $114.82 |
United Setting Professional Modifier None Typical Low $33.88 Median $64.57 Typical High $309.03 | Professional | None | $33.88 | $64.57 | $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 $30.20 Median $69.18 Typical High $229.09 | Facility | 52 · Reduced service | $30.20 | $69.18 | $229.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.02 Median $27.54 Typical High $91.20 | Facility | 53 · Discontinued | $12.02 | $27.54 | $91.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $44.67 Median $128.82 Typical High $346.74 | Facility | 54 · Surgery only | $44.67 | $128.82 | $346.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.91 Median $20.89 Typical High $69.18 | Facility | 55 · Aftercare only | $8.91 | $20.89 | $69.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.03 Median $13.80 Typical High $45.71 | Facility | 56 · Pre-op care only | $6.03 | $13.80 | $45.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $33.88 Typical High $46.77 | Professional | 52 · Reduced service | $30.20 | $33.88 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.49 Typical High $18.62 | Professional | 53 · Discontinued | $12.02 | $13.49 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $51.29 Typical High $72.44 | Professional | 54 · Surgery only | $44.67 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $10.23 Typical High $13.80 | Professional | 55 · Aftercare only | $8.91 | $10.23 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.76 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.03 | $6.76 | $9.33 |
Where California sits
The same service costs 4.9 times more in Alaska than in Georgia. 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· 40th of 51
$79.43
AK $224GA $45.71
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.