How much rates vary
Facilitymedian $912 · 10th to 90th $224 to $6,457Professionalmedian $204 · 10th to 90th $148 to $676
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 $478.63 Median $5,128.61 Typical High $15,135.61 | Facility | None | $478.63 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $380.19 | Professional | None | $162.18 | $204.17 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $177.83 Typical High $575.44 | Professional | None | $141.25 | $177.83 | $575.44 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,513.56 Typical High $4,897.79 | Facility | None | $100.00 | $1,513.56 | $4,897.79 |
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 $117.49 Median $213.80 Typical High $323.59 | Professional | None | $117.49 | $213.80 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $309.03 Typical High $1,412.54 | Facility | None | $194.98 | $309.03 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $354.81 | Professional | None | $169.82 | $218.78 | $354.81 |
Contra Costa Health Setting Professional Modifier None Typical Low $100.00 Median $208.93 Typical High $316.23 | Professional | None | $100.00 | $208.93 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $257.04 Typical High $537.03 | Professional | None | $165.96 | $257.04 | $537.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,659.59 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $323.59 | Professional | None | $194.98 | $194.98 | $323.59 |
Providence Setting Facility Modifier None Typical Low $199.53 Median $338.84 Typical High $2,454.71 | Facility | None | $199.53 | $338.84 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $354.81 | Professional | None | $169.82 | $218.78 | $354.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $741.31 | Professional | None | $575.44 | $575.44 | $741.31 |
United Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $3,090.30 | Facility | None | $446.68 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $389.05 | Professional | None | $138.04 | $199.53 | $389.05 |
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 $109.65 | Facility | 52 · Reduced service | $79.43 | $85.11 | $109.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $32.36 Median $34.67 Typical High $43.65 | Facility | 53 · Discontinued | $32.36 | $34.67 | $43.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $120.23 Median $128.82 Typical High $165.96 | Facility | 54 · Surgery only | $120.23 | $128.82 | $165.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $25.70 Typical High $33.11 | Facility | 55 · Aftercare only | $23.99 | $25.70 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.98 Typical High $21.88 | Facility | 56 · Pre-op care only | $16.22 | $16.98 | $21.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $120.23 Typical High $154.88 | Facility | 78 · Unplanned return to OR | $112.20 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $89.13 Typical High $104.71 | Professional | 52 · Reduced service | $77.62 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $35.48 Typical High $41.69 | Professional | 53 · Discontinued | $30.90 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $134.90 Typical High $154.88 | Professional | 54 · Surgery only | $114.82 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.92 Typical High $30.90 | Professional | 55 · Aftercare only | $23.44 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $17.78 Typical High $20.89 | Professional | 56 · Pre-op care only | $15.49 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $125.89 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $107.15 | $125.89 | $144.54 |
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· 39th of 51
$219
AK $724KY $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.