How much rates vary
Facilitymedian $933 · 10th to 90th $214 to $6,457Professionalmedian $158 · 10th to 90th $95 to $759
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 $107.15 Median $162.18 Typical High $239.88 | Professional | None | $107.15 | $162.18 | $239.88 |
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 $93.33 Median $151.36 Typical High $446.68 | Professional | None | $93.33 | $151.36 | $446.68 |
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 $72.44 Median $114.82 Typical High $208.93 | Professional | None | $72.44 | $114.82 | $208.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $288.40 | Professional | None | $102.33 | $144.54 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $295.12 Typical High $1,412.54 | Facility | None | $186.21 | $295.12 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $302.00 | Professional | None | $104.71 | $177.83 | $302.00 |
Contra Costa Health Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $281.84 | Professional | None | $85.11 | $144.54 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $218.78 Typical High $389.05 | Professional | None | $114.82 | $218.78 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,412.54 | $1,412.54 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $275.42 | Professional | None | $165.96 | $165.96 | $275.42 |
Providence Setting Facility Modifier None Typical Low $169.82 Median $331.13 Typical High $2,454.71 | Facility | None | $169.82 | $331.13 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $295.12 | Professional | None | $104.71 | $177.83 | $295.12 |
Sutter Health Plus Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $660.69 | Professional | None | $398.11 | $398.11 | $660.69 |
United Setting Facility Modifier None Typical Low $446.68 Median $933.25 Typical High $3,090.30 | Facility | None | $446.68 | $933.25 | $3,090.30 |
United Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $346.74 | Professional | None | $95.50 | $162.18 | $346.74 |
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 $53.70 Median $57.54 Typical High $95.50 | Facility | 52 · Reduced service | $53.70 | $57.54 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.38 Median $22.91 Typical High $38.90 | Facility | 53 · Discontinued | $21.38 | $22.91 | $38.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $81.28 Median $85.11 Typical High $144.54 | Facility | 54 · Surgery only | $81.28 | $85.11 | $144.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $16.98 Typical High $28.84 | Facility | 55 · Aftercare only | $16.22 | $16.98 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.48 Typical High $19.50 | Facility | 56 · Pre-op care only | $10.72 | $11.48 | $19.50 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $79.43 Typical High $134.90 | Facility | 78 · Unplanned return to OR | $75.86 | $79.43 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $75.86 Typical High $87.10 | Professional | 52 · Reduced service | $52.48 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $30.20 Typical High $35.48 | Professional | 53 · Discontinued | $20.89 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $112.20 Typical High $131.83 | Professional | 54 · Surgery only | $77.62 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $22.39 Typical High $26.30 | Professional | 55 · Aftercare only | $15.85 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.14 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.47 | $15.14 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $104.71 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $72.44 | $104.71 | $123.03 |
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· 38th of 51
$178
AK $501KY $138
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.