How much rates vary
Facilitymedian $355 · 10th to 90th $112 to $5,012Professionalmedian $102 · 10th to 90th $76 to $355
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 $109.65 Median $3,801.89 Typical High $13,803.84 | Facility | None | $109.65 | $3,801.89 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $204.17 | Professional | None | $85.11 | $109.65 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $144.54 | Professional | None | $114.82 | $123.03 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $316.23 | Professional | None | $75.86 | $89.13 | $316.23 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $1,479.11 | Facility | None | $97.72 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $141.25 | Professional | None | $63.10 | $89.13 | $141.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $51.29 Median $114.82 Typical High $186.21 | Professional | None | $51.29 | $114.82 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $138.04 Typical High $288.40 | Facility | None | $53.70 | $138.04 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $190.55 | Professional | None | $89.13 | $112.20 | $190.55 |
Contra Costa Health Setting Professional Modifier None Typical Low $42.66 Median $138.04 Typical High $181.97 | Professional | None | $42.66 | $138.04 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $331.13 | Professional | None | $107.15 | $147.91 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,096.48 | Professional | None | $933.25 | $933.25 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $177.83 | Professional | None | $107.15 | $107.15 | $177.83 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $138.04 Typical High $602.56 | Facility | None | $66.07 | $138.04 | $602.56 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $190.55 | Professional | None | $89.13 | $112.20 | $190.55 |
Sutter Health Plus Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $398.11 | Professional | None | $331.13 | $331.13 | $398.11 |
United Setting Facility Modifier None Typical Low $194.98 Median $354.81 Typical High $1,096.48 | Facility | None | $194.98 | $354.81 | $1,096.48 |
United Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $213.80 | Professional | None | $77.62 | $104.71 | $213.80 |
13 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 $42.66 Median $45.71 Typical High $56.23 | Facility | 52 · Reduced service | $42.66 | $45.71 | $56.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.98 Median $18.62 Typical High $22.39 | Facility | 53 · Discontinued | $16.98 | $18.62 | $22.39 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $64.57 Median $69.18 Typical High $83.18 | Facility | 54 · Surgery only | $64.57 | $69.18 | $83.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.88 Median $13.80 Typical High $16.60 | Facility | 55 · Aftercare only | $12.88 | $13.80 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.12 Typical High $11.22 | Facility | 56 · Pre-op care only | $8.51 | $9.12 | $11.22 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $64.57 Typical High $77.62 | Facility | 78 · Unplanned return to OR | $60.26 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $45.71 Typical High $56.23 | Professional | 52 · Reduced service | $41.69 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $18.62 Typical High $22.39 | Professional | 53 · Discontinued | $16.60 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $69.18 Typical High $83.18 | Professional | 54 · Surgery only | $61.66 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.80 Typical High $16.60 | Professional | 55 · Aftercare only | $12.30 | $13.80 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.12 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.32 | $9.12 | $11.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $64.57 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $57.54 | $64.57 | $77.62 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | 59 · Distinct service | $107.15 | $107.15 | $144.54 |
Where California sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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· 47th of 51
$112
AK $437KY $100
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.