How much rates vary
Facilitymedian $1,230 · 10th to 90th $151 to $7,079Professionalmedian $135 · 10th to 90th $91 to $447
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 $173.78 Median $5,754.40 Typical High $15,848.93 | Facility | None | $173.78 | $5,754.40 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $263.03 | Professional | None | $100.00 | $141.25 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $87.10 Median $123.03 Typical High $398.11 | Professional | None | $87.10 | $123.03 | $398.11 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,318.26 Typical High $4,786.30 | Facility | None | $100.00 | $1,318.26 | $4,786.30 |
Blue Shield Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $194.98 | Professional | None | $74.13 | $109.65 | $194.98 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $229.09 | Professional | None | $81.28 | $131.83 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $229.09 Typical High $1,412.54 | Facility | None | $141.25 | $229.09 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $245.47 | Professional | None | $104.71 | $147.91 | $245.47 |
Contra Costa Health Setting Professional Modifier None Typical Low $67.61 Median $131.83 Typical High $223.87 | Professional | None | $67.61 | $131.83 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $331.13 | Professional | None | $102.33 | $177.83 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,380.38 | Professional | None | $1,148.15 | $1,148.15 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $223.87 | Professional | None | $134.90 | $134.90 | $223.87 |
Providence Setting Facility Modifier None Typical Low $134.90 Median $269.15 Typical High $2,454.71 | Facility | None | $134.90 | $269.15 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $239.88 | Professional | None | $104.71 | $147.91 | $239.88 |
Sutter Health Plus Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $524.81 | Professional | None | $354.81 | $354.81 | $524.81 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $4,677.35 | Facility | None | $398.11 | $1,202.26 | $4,677.35 |
United Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $275.42 | Professional | None | $85.11 | $131.83 | $275.42 |
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 $50.12 Median $53.70 Typical High $77.62 | Facility | 52 · Reduced service | $50.12 | $53.70 | $77.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.95 Median $21.38 Typical High $30.90 | Facility | 53 · Discontinued | $19.95 | $21.38 | $30.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $74.13 Median $79.43 Typical High $117.49 | Facility | 54 · Surgery only | $74.13 | $79.43 | $117.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.14 Median $15.85 Typical High $23.44 | Facility | 55 · Aftercare only | $15.14 | $15.85 | $23.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.72 Typical High $15.49 | Facility | 56 · Pre-op care only | $10.00 | $10.72 | $15.49 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $74.13 Typical High $109.65 | Facility | 78 · Unplanned return to OR | $69.18 | $74.13 | $109.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $61.66 Typical High $70.79 | Professional | 52 · Reduced service | $46.77 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $24.55 Typical High $28.84 | Professional | 53 · Discontinued | $19.05 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $93.33 Typical High $107.15 | Professional | 54 · Surgery only | $70.79 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $18.62 Typical High $21.38 | Professional | 55 · Aftercare only | $14.13 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.33 | $12.30 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $87.10 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $66.07 | $87.10 | $100.00 |
Where California sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 45th of 51
$145
AK $447FL $126
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.