How much rates vary
Facilitymedian $933 · 10th to 90th $269 to $6,457Professionalmedian $240 · 10th to 90th $155 to $794
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 $346.74 Median $5,128.61 Typical High $15,135.61 | Facility | None | $346.74 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $457.09 | Professional | None | $173.78 | $257.04 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
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 $154.88 Median $223.87 Typical High $707.95 | Professional | None | $154.88 | $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 $120.23 Median $177.83 Typical High $316.23 | Professional | None | $120.23 | $177.83 | $316.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $173.78 Median $281.84 Typical High $389.05 | Professional | None | $173.78 | $281.84 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $346.74 Typical High $1,412.54 | Facility | None | $234.42 | $346.74 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $426.58 | Professional | None | $173.78 | $251.19 | $426.58 |
Contra Costa Health Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $389.05 | Professional | None | $169.82 | $208.93 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $537.03 | Professional | None | $169.82 | $302.00 | $537.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,995.26 | $1,995.26 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $389.05 | Professional | None | $234.42 | $234.42 | $389.05 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $371.54 Typical High $2,454.71 | Facility | None | $229.09 | $371.54 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $426.58 | Professional | None | $169.82 | $251.19 | $426.58 |
Sutter Health Plus Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $933.25 | Professional | None | $630.96 | $630.96 | $933.25 |
United Setting Facility Modifier None Typical Low $446.68 Median $933.25 Typical High $3,019.95 | Facility | None | $446.68 | $933.25 | $3,019.95 |
United Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $489.78 | Professional | None | $151.36 | $234.42 | $489.78 |
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 $87.10 Median $93.33 Typical High $141.25 | Facility | 52 · Reduced service | $87.10 | $93.33 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $34.67 Median $37.15 Typical High $56.23 | Facility | 53 · Discontinued | $34.67 | $37.15 | $56.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $131.83 Median $138.04 Typical High $208.93 | Facility | 54 · Surgery only | $131.83 | $138.04 | $208.93 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.30 Median $28.18 Typical High $42.66 | Facility | 55 · Aftercare only | $26.30 | $28.18 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $18.62 Typical High $28.18 | Facility | 56 · Pre-op care only | $17.38 | $18.62 | $28.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $128.82 Typical High $194.98 | Facility | 78 · Unplanned return to OR | $123.03 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $107.15 Typical High $128.82 | Professional | 52 · Reduced service | $83.18 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $43.65 Typical High $51.29 | Professional | 53 · Discontinued | $33.11 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $162.18 Typical High $194.98 | Professional | 54 · Surgery only | $125.89 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $32.36 Typical High $38.90 | Professional | 55 · Aftercare only | $25.12 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $21.88 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.60 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $151.36 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $117.49 | $151.36 | $181.97 |
Where California sits
The same service costs 3.6 times more in Alaska than in Texas. 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
$257
AK $776TX $214
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.