How much rates vary
Facilitymedian $1,259 · 10th to 90th $417 to $6,457Professionalmedian $251 · 10th to 90th $186 to $933
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 $363.08 Median $5,128.61 Typical High $15,135.61 | Facility | None | $363.08 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $478.63 | Professional | None | $204.17 | $251.19 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
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 $181.97 Median $223.87 Typical High $707.95 | Professional | None | $181.97 | $223.87 | $707.95 |
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 $158.49 Median $229.09 Typical High $371.54 | Professional | None | $158.49 | $229.09 | $371.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $147.91 Median $263.03 Typical High $407.38 | Professional | None | $147.91 | $263.03 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,148.15 Typical High $1,949.84 | Facility | None | $426.58 | $1,148.15 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $436.52 | Professional | None | $218.78 | $275.42 | $436.52 |
Contra Costa Health Setting Professional Modifier None Typical Low $123.03 Median $257.04 Typical High $398.11 | Professional | None | $123.03 | $257.04 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $660.69 | Professional | None | $208.93 | $316.23 | $660.69 |
Lucent Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,454.71 | Professional | None | $2,041.74 | $2,041.74 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $398.11 | Professional | None | $239.88 | $239.88 | $398.11 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $1,122.02 Typical High $2,754.23 | Facility | None | $331.13 | $1,122.02 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $446.68 | Professional | None | $213.80 | $275.42 | $446.68 |
Sutter Health Plus Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $933.25 | Professional | None | $741.31 | $741.31 | $933.25 |
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 $173.78 Median $251.19 Typical High $478.63 | Professional | None | $173.78 | $251.19 | $478.63 |
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 $102.33 Median $107.15 Typical High $138.04 | Facility | 52 · Reduced service | $102.33 | $107.15 | $138.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $40.74 Median $42.66 Typical High $54.95 | Facility | 53 · Discontinued | $40.74 | $42.66 | $54.95 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $151.36 Median $162.18 Typical High $204.17 | Facility | 54 · Surgery only | $151.36 | $162.18 | $204.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $32.36 Typical High $40.74 | Facility | 55 · Aftercare only | $30.20 | $32.36 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.38 Typical High $27.54 | Facility | 56 · Pre-op care only | $20.42 | $21.38 | $27.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $151.36 Typical High $190.55 | Facility | 78 · Unplanned return to OR | $141.25 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $112.20 Typical High $128.82 | Professional | 52 · Reduced service | $97.72 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $44.67 Typical High $51.29 | Professional | 53 · Discontinued | $38.90 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $165.96 Typical High $194.98 | Professional | 54 · Surgery only | $147.91 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $33.11 Typical High $38.90 | Professional | 55 · Aftercare only | $29.51 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $22.39 Typical High $25.70 | Professional | 56 · Pre-op care only | $19.50 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $154.88 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $138.04 | $154.88 | $181.97 |
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· 41st of 51
$275
AK $912KY $234
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.