How much rates vary
Facilitymedian $1,622 · 10th to 90th $407 to $7,244Professionalmedian $191 · 10th to 90th $132 to $646
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 $229.09 Median $4,897.79 Typical High $15,135.61 | Facility | None | $229.09 | $4,897.79 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $380.19 | Professional | None | $144.54 | $194.98 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $229.09 | Professional | None | $114.82 | $128.82 | $229.09 |
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 $125.89 Median $169.82 Typical High $562.34 | Professional | None | $125.89 | $169.82 | $562.34 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,548.82 Typical High $5,011.87 | Facility | None | $100.00 | $1,548.82 | $5,011.87 |
Blue Shield Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $263.03 | Professional | None | $102.33 | $151.36 | $263.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $331.13 | Professional | None | $107.15 | $190.55 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,148.15 Typical High $2,344.23 | Facility | None | $426.58 | $1,148.15 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $346.74 | Professional | None | $144.54 | $204.17 | $346.74 |
Contra Costa Health Setting Professional Modifier None Typical Low $89.13 Median $199.53 Typical High $323.59 | Professional | None | $89.13 | $199.53 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $501.19 | Professional | None | $158.49 | $257.04 | $501.19 |
Lucent Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,621.81 | $1,621.81 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $316.23 | Professional | None | $190.55 | $190.55 | $316.23 |
Providence Setting Facility Modifier None Typical Low $257.04 Median $1,122.02 Typical High $3,235.94 | Facility | None | $257.04 | $1,122.02 | $3,235.94 |
Providence Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $346.74 | Professional | None | $144.54 | $199.53 | $346.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $724.44 | Professional | None | $524.81 | $524.81 | $724.44 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $380.19 | Professional | None | $125.89 | $190.55 | $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 $72.44 Median $75.86 Typical High $107.15 | Facility | 52 · Reduced service | $72.44 | $75.86 | $107.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.84 Median $30.20 Typical High $42.66 | Facility | 53 · Discontinued | $28.84 | $30.20 | $42.66 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $107.15 Median $114.82 Typical High $158.49 | Facility | 54 · Surgery only | $107.15 | $114.82 | $158.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.38 Median $22.91 Typical High $31.62 | Facility | 55 · Aftercare only | $21.38 | $22.91 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.14 Typical High $21.38 | Facility | 56 · Pre-op care only | $14.45 | $15.14 | $21.38 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $107.15 Typical High $147.91 | Facility | 78 · Unplanned return to OR | $100.00 | $107.15 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $85.11 Typical High $97.72 | Professional | 52 · Reduced service | $70.79 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $33.88 Typical High $38.90 | Professional | 53 · Discontinued | $28.18 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $128.82 Typical High $144.54 | Professional | 54 · Surgery only | $107.15 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $25.70 Typical High $29.51 | Professional | 55 · Aftercare only | $21.38 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.98 Typical High $19.50 | Professional | 56 · Pre-op care only | $14.13 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $120.23 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $100.00 | $120.23 | $134.90 |
Where California sits
The same service costs 4.6 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· 49th of 51
$200
AK $794KY $174
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.