How much rates vary
Facilitymedian $5,012 · 10th to 90th $79 to $12,882Professionalmedian $5,012 · 10th to 90th $4,898 to $24,547
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 $4,897.79 Median $7,585.78 Typical High $12,589.25 | Facility | None | $4,897.79 | $7,585.78 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.04 Median $6,760.83 Typical High $17,782.79 | Facility | None | $0.04 | $6,760.83 | $17,782.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $6,165.95 | Professional | None | $5,011.87 | $5,011.87 | $6,165.95 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $5,011.87 Typical High $8,511.38 | Facility | None | $75.86 | $5,011.87 | $8,511.38 |
Blue Shield Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $6,456.54 | Professional | None | $5,248.07 | $5,248.07 | $6,456.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $5,128.61 Median $7,762.47 Typical High $7,762.47 | Professional | None | $5,128.61 | $7,762.47 | $7,762.47 |
Cigna Setting Facility Modifier None Typical Low $5,011.87 Median $10,000.00 Typical High $15,135.61 | Facility | None | $5,011.87 | $10,000.00 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Contra Costa Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,165.95 | Professional | None | $5,128.61 | $5,128.61 | $6,165.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $6,309.57 Typical High $10,964.78 | Professional | None | $630.96 | $6,309.57 | $10,964.78 |
Lucent Health Setting Professional Modifier None Typical Low $24,547.09 Median $24,547.09 Typical High $40,738.03 | Professional | None | $24,547.09 | $24,547.09 | $40,738.03 |
Molina 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 |
Providence Setting Facility Modifier None Typical Low $4,897.79 Median $6,918.31 Typical High $13,489.63 | Facility | None | $4,897.79 | $6,918.31 | $13,489.63 |
Providence Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Professional | None | $8,128.31 | $8,128.31 | $8,128.31 |
United Setting Facility Modifier None Typical Low $14,454.40 Median $14,454.40 Typical High $14,454.40 | Facility | None | $14,454.40 | $14,454.40 | $14,454.40 |
United Setting Professional Modifier None Typical Low $4,897.79 Median $5,128.61 Typical High $6,165.95 | Professional | None | $4,897.79 | $5,128.61 | $6,165.95 |
8 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 $2,454.71 Median $3,801.89 Typical High $6,309.57 | Facility | 52 · Reduced service | $2,454.71 | $3,801.89 | $6,309.57 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $977.24 Median $1,513.56 Typical High $2,511.89 | Facility | 53 · Discontinued | $977.24 | $1,513.56 | $2,511.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $724.44 Median $1,148.15 Typical High $1,905.46 | Facility | 55 · Aftercare only | $724.44 | $1,148.15 | $1,905.46 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $489.78 Median $758.58 Typical High $1,258.93 | Facility | 56 · Pre-op care only | $489.78 | $758.58 | $1,258.93 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 52 · Reduced service | $2,454.71 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 53 · Discontinued | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 55 · Aftercare only | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 56 · Pre-op care only | $489.78 | $489.78 | $489.78 |
Where California sits
The same service costs 1.8 times more in Alaska than in North Carolina. 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· 32nd of 51
$5,012
AK $7,244NC $3,981
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.