How much rates vary
Facilitymedian $525 · 10th to 90th $209 to $5,129Professionalmedian $155 · 10th to 90th $83 to $661
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 $177.83 Median $4,570.88 Typical High $15,135.61 | Facility | None | $177.83 | $4,570.88 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $158.49 Typical High $331.13 | Professional | None | $89.13 | $158.49 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $131.83 Typical High $489.78 | Professional | None | $77.62 | $131.83 | $489.78 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $1,548.82 | Facility | None | $97.72 | $416.87 | $1,548.82 |
Blue Shield Setting Professional Modifier None Typical Low $67.61 Median $123.03 Typical High $223.87 | Professional | None | $67.61 | $123.03 | $223.87 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $66.07 Median $117.49 Typical High $407.38 | Professional | None | $66.07 | $117.49 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $363.08 Typical High $676.08 | Facility | None | $53.70 | $363.08 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $173.78 Typical High $316.23 | Professional | None | $95.50 | $173.78 | $316.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $54.95 Median $141.25 Typical High $398.11 | Professional | None | $54.95 | $141.25 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $288.40 Typical High $537.03 | Professional | None | $112.20 | $288.40 | $537.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,778.28 | $1,778.28 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $346.74 | Professional | None | $208.93 | $208.93 | $346.74 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $338.84 Typical High $676.08 | Facility | None | $58.88 | $338.84 | $676.08 |
Providence Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $316.23 | Professional | None | $95.50 | $169.82 | $316.23 |
Sutter Health Plus Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $707.95 | Professional | None | $338.84 | $338.84 | $707.95 |
United Setting Facility Modifier None Typical Low $446.68 Median $524.81 Typical High $3,090.30 | Facility | None | $446.68 | $524.81 | $3,090.30 |
United Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $380.19 | Professional | None | $79.43 | $162.18 | $380.19 |
12 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 $44.67 Median $47.86 Typical High $89.13 | Facility | 52 · Reduced service | $44.67 | $47.86 | $89.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $19.50 Typical High $35.48 | Facility | 53 · Discontinued | $18.20 | $19.50 | $35.48 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $67.61 Median $72.44 Typical High $131.83 | Facility | 54 · Surgery only | $67.61 | $72.44 | $131.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $14.45 Typical High $26.30 | Facility | 55 · Aftercare only | $13.49 | $14.45 | $26.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.55 Typical High $17.78 | Facility | 56 · Pre-op care only | $8.91 | $9.55 | $17.78 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $67.61 Typical High $123.03 | Facility | 78 · Unplanned return to OR | $63.10 | $67.61 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $64.57 Typical High $89.13 | Professional | 52 · Reduced service | $44.67 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $26.30 Typical High $35.48 | Professional | 53 · Discontinued | $17.78 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $97.72 Typical High $131.83 | Professional | 54 · Surgery only | $66.07 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $19.50 Typical High $26.30 | Professional | 55 · Aftercare only | $13.18 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.88 Typical High $17.78 | Professional | 56 · Pre-op care only | $8.91 | $12.88 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $91.20 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $61.66 | $91.20 | $123.03 |
Where California sits
The same service costs 4.1 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· 48th of 51
$166
AK $501KY $123
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.