How much rates vary
Facilitymedian $813 · 10th to 90th $126 to $1,778Professionalmedian $151 · 10th to 90th $126 to $479
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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $218.78 | Professional | None | $151.36 | $158.49 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $190.55 Typical High $776.25 | Facility | None | $147.91 | $190.55 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $331.13 | Professional | None | $151.36 | $151.36 | $331.13 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $1,047.13 Typical High $2,187.76 | Facility | None | $91.20 | $1,047.13 | $2,187.76 |
Blue Shield Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $208.93 | Professional | None | $112.20 | $158.49 | $208.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $204.17 | Professional | None | $151.36 | $151.36 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $234.42 Typical High $316.23 | Facility | None | $131.83 | $234.42 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $190.55 | Professional | None | $151.36 | $165.96 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $331.13 | Professional | None | $134.90 | $165.96 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,096.48 | Professional | None | $660.69 | $660.69 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $213.80 Typical High $316.23 | Facility | None | $131.83 | $213.80 | $316.23 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $131.83 | Professional | None | $125.89 | $125.89 | $131.83 |
Sutter Health Plus Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
United Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $177.83 | Professional | None | $125.89 | $125.89 | $177.83 |
4 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 $75.86 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.14 |
Where California sits
The same service costs 2.9 times more in Wyoming 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
$151
WY $339NC $117
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.