How much rates vary
Facilitymedian $1,230 · 10th to 90th $186 to $6,918Professionalmedian $174 · 10th to 90th $120 to $575
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 $251.19 Median $4,897.79 Typical High $15,135.61 | Facility | None | $251.19 | $4,897.79 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $323.59 | Professional | None | $131.83 | $173.78 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $194.98 | Professional | None | $93.33 | $93.33 | $194.98 |
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 $114.82 Median $147.91 Typical High $478.63 | Professional | None | $114.82 | $147.91 | $478.63 |
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 $97.72 Median $141.25 Typical High $239.88 | Professional | None | $97.72 | $141.25 | $239.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $275.42 | Professional | None | $95.50 | $169.82 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $275.42 Typical High $1,412.54 | Facility | None | $173.78 | $275.42 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $302.00 | Professional | None | $138.04 | $177.83 | $302.00 |
Contra Costa Health Setting Professional Modifier None Typical Low $79.43 Median $177.83 Typical High $275.42 | Professional | None | $79.43 | $177.83 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $436.52 | Professional | None | $138.04 | $218.78 | $436.52 |
Lucent Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,380.38 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $269.15 | Professional | None | $162.18 | $162.18 | $269.15 |
Providence Setting Facility Modifier None Typical Low $169.82 Median $323.59 Typical High $2,454.71 | Facility | None | $169.82 | $323.59 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $302.00 | Professional | None | $138.04 | $177.83 | $302.00 |
Sutter Health Plus Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $630.96 | Professional | None | $478.63 | $478.63 | $630.96 |
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 $112.20 Median $165.96 Typical High $331.13 | Professional | None | $112.20 | $165.96 | $331.13 |
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 $66.07 Median $70.79 Typical High $93.33 | Facility | 52 · Reduced service | $66.07 | $70.79 | $93.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $28.18 Typical High $37.15 | Facility | 53 · Discontinued | $26.30 | $28.18 | $37.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $97.72 Median $107.15 Typical High $141.25 | Facility | 54 · Surgery only | $97.72 | $107.15 | $141.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.95 Median $21.38 Typical High $28.18 | Facility | 55 · Aftercare only | $19.95 | $21.38 | $28.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.13 Typical High $18.62 | Facility | 56 · Pre-op care only | $13.18 | $14.13 | $18.62 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $100.00 Typical High $131.83 | Facility | 78 · Unplanned return to OR | $91.20 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $75.86 Typical High $93.33 | Professional | 52 · Reduced service | $63.10 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.20 Typical High $37.15 | Professional | 53 · Discontinued | $25.12 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $112.20 Typical High $141.25 | Professional | 54 · Surgery only | $95.50 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $22.39 Typical High $28.18 | Professional | 55 · Aftercare only | $19.05 | $22.39 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.14 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.59 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $104.71 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $89.13 | $104.71 | $131.83 |
Where California sits
The same service costs 3.9 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· 44th of 51
$178
AK $603KY $155
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.