How much rates vary
Facilitymedian $417 · 10th to 90th $100 to $5,623Professionalmedian $126 · 10th to 90th $78 to $437
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 $125.89 Median $4,365.16 Typical High $14,791.08 | Facility | None | $125.89 | $4,365.16 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $245.47 | Professional | None | $83.18 | $125.89 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $331.13 | Professional | None | $123.03 | $158.49 | $331.13 |
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 $74.13 Median $109.65 Typical High $380.19 | Professional | None | $74.13 | $109.65 | $380.19 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $426.58 Typical High $1,479.11 | Facility | None | $97.72 | $426.58 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $181.97 | Professional | None | $64.57 | $100.00 | $181.97 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $61.66 Median $117.49 Typical High $229.09 | Professional | None | $61.66 | $117.49 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $181.97 Typical High $380.19 | Facility | None | $53.70 | $181.97 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $239.88 | Professional | None | $91.20 | $141.25 | $239.88 |
Contra Costa Health Setting Professional Modifier None Typical Low $51.29 Median $141.25 Typical High $223.87 | Professional | None | $51.29 | $141.25 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $354.81 | Professional | None | $107.15 | $177.83 | $354.81 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,096.48 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $213.80 | Professional | None | $125.89 | $125.89 | $213.80 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $177.83 Typical High $380.19 | Facility | None | $61.66 | $177.83 | $380.19 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $234.42 | Professional | None | $91.20 | $141.25 | $234.42 |
Sutter Health Plus Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $501.19 | Professional | None | $338.84 | $338.84 | $501.19 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,090.30 | Facility | None | $123.03 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $269.15 | Professional | None | $79.43 | $125.89 | $269.15 |
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 $41.69 Median $44.67 Typical High $69.18 | Facility | 52 · Reduced service | $41.69 | $44.67 | $69.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.60 Median $17.78 Typical High $28.18 | Facility | 53 · Discontinued | $16.60 | $17.78 | $28.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $61.66 Median $66.07 Typical High $104.71 | Facility | 54 · Surgery only | $61.66 | $66.07 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $13.18 Typical High $20.89 | Facility | 55 · Aftercare only | $12.30 | $13.18 | $20.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.91 Typical High $14.13 | Facility | 56 · Pre-op care only | $8.32 | $8.91 | $14.13 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $61.66 Typical High $97.72 | Facility | 78 · Unplanned return to OR | $57.54 | $61.66 | $97.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $56.23 Typical High $66.07 | Professional | 52 · Reduced service | $41.69 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $22.39 Typical High $26.30 | Professional | 53 · Discontinued | $16.60 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $83.18 Typical High $97.72 | Professional | 54 · Surgery only | $61.66 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.60 Typical High $19.50 | Professional | 55 · Aftercare only | $12.30 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $11.22 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.32 | $11.22 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $77.62 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $57.54 | $77.62 | $91.20 |
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· 46th of 51
$132
AK $447KY $110
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.