How much rates vary
Facilitymedian $1,047 · 10th to 90th $447 to $7,079Professionalmedian $263 · 10th to 90th $170 to $891
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 $5,754.40 Typical High $15,848.93 | Facility | None | $478.63 | $5,754.40 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $524.81 | Professional | None | $190.55 | $288.40 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
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 $169.82 Median $245.47 Typical High $776.25 | Professional | None | $169.82 | $245.47 | $776.25 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,513.56 Typical High $6,309.57 | Facility | None | $100.00 | $1,513.56 | $6,309.57 |
Blue Shield Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $346.74 | Professional | None | $131.83 | $194.98 | $346.74 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $436.52 | Professional | None | $190.55 | $309.03 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $691.83 Typical High $1,862.09 | Facility | None | $478.63 | $691.83 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $478.63 | Professional | None | $190.55 | $275.42 | $478.63 |
Contra Costa Health Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $436.52 | Professional | None | $181.97 | $229.09 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $338.84 Typical High $602.56 | Professional | None | $186.21 | $338.84 | $602.56 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,691.53 | Professional | None | $2,238.72 | $2,238.72 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $436.52 | Professional | None | $263.03 | $263.03 | $436.52 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $691.83 Typical High $3,311.31 | Facility | None | $371.54 | $691.83 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $478.63 | Professional | None | $186.21 | $275.42 | $478.63 |
Sutter Health Plus Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,023.29 | Professional | None | $691.83 | $691.83 | $1,023.29 |
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 $165.96 Median $263.03 Typical High $537.03 | Professional | None | $165.96 | $263.03 | $537.03 |
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 $95.50 Median $100.00 Typical High $154.88 | Facility | 52 · Reduced service | $95.50 | $100.00 | $154.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.02 Median $40.74 Typical High $61.66 | Facility | 53 · Discontinued | $38.02 | $40.74 | $61.66 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $144.54 Median $151.36 Typical High $234.42 | Facility | 54 · Surgery only | $144.54 | $151.36 | $234.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $30.20 Typical High $46.77 | Facility | 55 · Aftercare only | $28.84 | $30.20 | $46.77 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.42 Typical High $30.90 | Facility | 56 · Pre-op care only | $19.05 | $20.42 | $30.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $141.25 Typical High $218.78 | Facility | 78 · Unplanned return to OR | $134.90 | $141.25 | $218.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $120.23 Typical High $141.25 | Professional | 52 · Reduced service | $91.20 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $47.86 Typical High $57.54 | Professional | 53 · Discontinued | $36.31 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $181.97 Typical High $213.80 | Professional | 54 · Surgery only | $138.04 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $36.31 Typical High $42.66 | Professional | 55 · Aftercare only | $27.54 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $23.99 Typical High $28.84 | Professional | 56 · Pre-op care only | $18.20 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $169.82 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $128.82 | $169.82 | $199.53 |
Where California sits
The same service costs 3.6 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· 40th of 51
$288
AK $851KY $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.