How much rates vary
Facilitymedian $251 · 10th to 90th $95 to $479Professionalmedian $174 · 10th to 90th $162 to $209
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 $173.78 Median $257.04 Typical High $436.52 | Facility | None | $173.78 | $257.04 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $239.88 | Professional | None | $173.78 | $173.78 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $186.21 Median $288.40 Typical High $588.84 | Facility | None | $186.21 | $288.40 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $223.87 | Professional | None | $169.82 | $169.82 | $223.87 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $169.82 Typical High $257.04 | Facility | None | $77.62 | $169.82 | $257.04 |
Blue Shield Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $213.80 | Professional | None | $173.78 | $173.78 | $213.80 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | None | $173.78 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $316.23 Typical High $436.52 | Facility | None | $173.78 | $316.23 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $194.98 | Professional | None | $162.18 | $165.96 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $173.78 Typical High $309.03 | Professional | None | $154.88 | $173.78 | $309.03 |
Lucent Health Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $302.00 | Professional | None | $165.96 | $186.21 | $302.00 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Providence Setting Facility Modifier None Typical Low $173.78 Median $309.03 Typical High $478.63 | Facility | None | $173.78 | $309.03 | $478.63 |
Providence Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $380.19 | Facility | None | $173.78 | $173.78 | $380.19 |
United Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $194.98 | Professional | None | $144.54 | $162.18 | $194.98 |
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 $87.10 Median $128.82 Typical High $213.80 | Facility | 52 · Reduced service | $87.10 | $128.82 | $213.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $34.67 Median $51.29 Typical High $87.10 | Facility | 53 · Discontinued | $34.67 | $51.29 | $87.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $128.82 Median $204.17 Typical High $323.59 | Facility | 54 · Surgery only | $128.82 | $204.17 | $323.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $38.02 Typical High $64.57 | Facility | 55 · Aftercare only | $25.70 | $38.02 | $64.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $25.70 Typical High $43.65 | Facility | 56 · Pre-op care only | $17.38 | $25.70 | $43.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 54 · Surgery only | $128.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $25.70 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $17.38 |
Where California sits
Rates are fairly even across states for this service. 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· 14th of 51
$174
AK $214AZ $166
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.