How much rates vary
Facilitymedian $112 · 10th to 90th $76 to $219Professionalmedian $78 · 10th to 90th $76 to $91
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 $75.86 Median $117.49 Typical High $199.53 | Facility | None | $75.86 | $117.49 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $107.15 | Professional | None | $75.86 | $81.28 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $125.89 Typical High $269.15 | Facility | None | $83.18 | $125.89 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $102.33 | Professional | None | $77.62 | $77.62 | $102.33 |
Blue Shield Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $131.83 | Facility | None | $70.79 | $83.18 | $131.83 |
Blue Shield Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $95.50 | Professional | None | $77.62 | $77.62 | $95.50 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $85.11 | Professional | None | $75.86 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $141.25 Typical High $190.55 | Facility | None | $75.86 | $141.25 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Contra Costa Health Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $91.20 | Professional | None | $74.13 | $75.86 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $141.25 | Professional | None | $69.18 | $75.86 | $141.25 |
Lucent Health Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $138.04 | Professional | None | $83.18 | $85.11 | $138.04 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Providence Setting Facility Modifier None Typical Low $75.86 Median $138.04 Typical High $213.80 | Facility | None | $75.86 | $138.04 | $213.80 |
Providence Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Sutter Health Plus Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $199.53 | Facility | None | $75.86 | $75.86 | $199.53 |
United Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $91.20 | Professional | None | $70.79 | $75.86 | $91.20 |
11 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 $38.02 Median $58.88 Typical High $100.00 | Facility | 52 · Reduced service | $38.02 | $58.88 | $100.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.14 Median $23.44 Typical High $39.81 | Facility | 53 · Discontinued | $15.14 | $23.44 | $39.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $57.54 Median $93.33 Typical High $147.91 | Facility | 54 · Surgery only | $57.54 | $93.33 | $147.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $17.78 Typical High $29.51 | Facility | 55 · Aftercare only | $11.48 | $17.78 | $29.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $11.75 Typical High $19.95 | Facility | 56 · Pre-op care only | $7.59 | $11.75 | $19.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $38.02 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $15.14 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 54 · Surgery only | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.59 | $7.76 | $7.76 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | JZ · No drug discarded | $75.86 | $75.86 | $75.86 |
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· 17th of 51
$77.62
AK $93.33NJ $75.86
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.