How much rates vary
Facilitymedian $1,288 · 10th to 90th $83 to $2,754Professionalmedian $1,288 · 10th to 90th $1,259 to $2,512
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 $1,258.93 Median $1,258.93 Typical High $2,570.40 | Facility | None | $1,258.93 | $1,258.93 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,412.54 | $2,511.89 |
Ambetter Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,495.41 | $5,495.41 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,905.46 | Facility | None | $1,288.25 | $1,513.56 | $1,905.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,288.25 Typical High $2,511.89 | Professional | None | $870.96 | $1,288.25 | $2,511.89 |
Blue Shield Setting Facility Modifier None Typical Low $74.13 Median $1,288.25 Typical High $1,819.70 | Facility | None | $74.13 | $1,288.25 | $1,819.70 |
Blue Shield Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $3,235.94 | Professional | None | $1,412.54 | $1,621.81 | $3,235.94 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,659.59 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,570.40 Typical High $3,890.45 | Facility | None | $1,288.25 | $2,570.40 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $1,548.82 Typical High $3,235.94 | Professional | None | $616.60 | $1,548.82 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $3,548.13 | Facility | None | $1,288.25 | $1,819.70 | $3,548.13 |
Providence Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
United Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $3,388.44 | Professional | None | $1,258.93 | $1,258.93 | $3,388.44 |
5 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 Professional Modifier 52 · Reduced service Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $125.89 |
Where California sits
The same service costs 2.9 times more in Minnesota than in Alabama. 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· 16th of 51
$1,288
MN $2,239AL $776
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.