How much rates vary
Facilitymedian $1,660 · 10th to 90th $501 to $7,943Professionalmedian $209 · 10th to 90th $148 to $692
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 $269.15 Median $5,754.40 Typical High $15,848.93 | Facility | None | $269.15 | $5,754.40 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $407.38 | Professional | None | $158.49 | $208.93 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $281.84 | Professional | None | $234.42 | $281.84 | $281.84 |
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 $141.25 Median $181.97 Typical High $602.56 | Professional | None | $141.25 | $181.97 | $602.56 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,584.89 Typical High $6,309.57 | Facility | None | $100.00 | $1,584.89 | $6,309.57 |
Blue Shield Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $295.12 | Professional | None | $120.23 | $173.78 | $295.12 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $346.74 | Professional | None | $120.23 | $218.78 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $2,454.71 | Facility | None | $575.44 | $1,174.90 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $363.08 | Professional | None | $169.82 | $218.78 | $363.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $102.33 Median $213.80 Typical High $338.84 | Professional | None | $102.33 | $213.80 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $549.54 | Professional | None | $169.82 | $269.15 | $549.54 |
Lucent Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,089.30 | Professional | None | $1,737.80 | $1,737.80 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $338.84 | Professional | None | $199.53 | $199.53 | $338.84 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $1,148.15 Typical High $3,801.89 | Facility | None | $302.00 | $1,148.15 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $363.08 | Professional | None | $169.82 | $218.78 | $363.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $776.25 | Professional | None | $575.44 | $575.44 | $776.25 |
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 $138.04 Median $204.17 Typical High $398.11 | Professional | None | $138.04 | $204.17 | $398.11 |
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 $79.43 Median $85.11 Typical High $112.20 | Facility | 52 · Reduced service | $79.43 | $85.11 | $112.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $31.62 Median $33.88 Typical High $45.71 | Facility | 53 · Discontinued | $31.62 | $33.88 | $45.71 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $120.23 Median $125.89 Typical High $169.82 | Facility | 54 · Surgery only | $120.23 | $125.89 | $169.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $25.70 Typical High $33.88 | Facility | 55 · Aftercare only | $23.99 | $25.70 | $33.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.98 Typical High $22.91 | Facility | 56 · Pre-op care only | $15.85 | $16.98 | $22.91 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $117.49 Typical High $158.49 | Facility | 78 · Unplanned return to OR | $112.20 | $117.49 | $158.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $77.62 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $37.15 Typical High $41.69 | Professional | 53 · Discontinued | $30.90 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $138.04 Typical High $158.49 | Professional | 54 · Surgery only | $117.49 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $27.54 Typical High $31.62 | Professional | 55 · Aftercare only | $23.44 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $15.49 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $128.82 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $109.65 | $128.82 | $147.91 |
Where California sits
The same service costs 4.7 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
$219
AK $871KY $186
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.