How much rates vary
Facilitymedian $759 · 10th to 90th $95 to $1,445Professionalmedian $525 · 10th to 90th $513 to $1,288
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 $512.86 Median $524.81 Typical High $933.25 | Facility | None | $512.86 | $524.81 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $724.44 | Professional | None | $512.86 | $562.34 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $851.14 Typical High $1,778.28 | Facility | None | $562.34 | $851.14 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $512.86 Typical High $1,348.96 | Professional | None | $501.19 | $512.86 | $1,348.96 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $501.19 Typical High $1,000.00 | Facility | None | $77.62 | $501.19 | $1,000.00 |
Blue Shield Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $1,412.54 | Professional | None | $512.86 | $630.96 | $1,412.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $758.58 | Professional | None | $467.74 | $562.34 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $954.99 Typical High $1,288.25 | Facility | None | $537.03 | $954.99 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Contra Costa Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,380.38 | Professional | None | $467.74 | $616.60 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Providence Setting Facility Modifier None Typical Low $512.86 Median $933.25 Typical High $1,445.44 | Facility | None | $512.86 | $933.25 | $1,445.44 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $912.01 | Professional | None | $512.86 | $512.86 | $912.01 |
Sutter Health Plus Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
United Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $1,659.59 | Facility | None | $512.86 | $512.86 | $1,659.59 |
United Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,380.38 | Professional | None | $512.86 | $512.86 | $1,380.38 |
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 $257.04 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $257.04 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $102.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $51.29 | $52.48 | $52.48 |
Where California sits
The same service costs 1.6 times more in Arizona than in Wyoming. 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· 15th of 51
$562
AZ $813WY $513
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.