How much rates vary
Facilitymedian $933 · 10th to 90th $234 to $6,457Professionalmedian $195 · 10th to 90th $123 to $741
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 $134.90 Median $208.93 Typical High $363.08 | Professional | None | $134.90 | $208.93 | $363.08 |
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 $120.23 Median $181.97 Typical High $549.54 | Professional | None | $120.23 | $181.97 | $549.54 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,318.26 Typical High $4,677.35 | Facility | None | $100.00 | $1,318.26 | $4,677.35 |
Blue Shield Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $257.04 | Professional | None | $93.33 | $141.25 | $257.04 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $331.13 | Professional | None | $141.25 | $181.97 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $323.59 Typical High $1,047.13 | Facility | None | $204.17 | $323.59 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $354.81 | Professional | None | $134.90 | $204.17 | $354.81 |
Contra Costa Health Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $323.59 | Professional | None | $125.89 | $169.82 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $446.68 | Professional | None | $134.90 | $251.19 | $446.68 |
Lucent Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,659.59 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $323.59 | Professional | None | $190.55 | $190.55 | $323.59 |
Providence Setting Facility Modifier None Typical Low $194.98 Median $346.74 Typical High $2,454.71 | Facility | None | $194.98 | $346.74 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $346.74 | Professional | None | $134.90 | $204.17 | $346.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $758.58 | Professional | None | $489.78 | $489.78 | $758.58 |
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 $114.82 Median $190.55 Typical High $398.11 | Professional | None | $114.82 | $190.55 | $398.11 |
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 $67.61 Median $72.44 Typical High $114.82 | Facility | 52 · Reduced service | $67.61 | $72.44 | $114.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.92 Median $28.84 Typical High $46.77 | Facility | 53 · Discontinued | $26.92 | $28.84 | $46.77 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $102.33 Median $109.65 Typical High $173.78 | Facility | 54 · Surgery only | $102.33 | $109.65 | $173.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.42 Median $21.88 Typical High $34.67 | Facility | 55 · Aftercare only | $20.42 | $21.88 | $34.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.45 Typical High $22.91 | Facility | 56 · Pre-op care only | $13.49 | $14.45 | $22.91 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $102.33 Typical High $162.18 | Facility | 78 · Unplanned return to OR | $95.50 | $102.33 | $162.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $89.13 Typical High $104.71 | Professional | 52 · Reduced service | $64.57 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $35.48 Typical High $42.66 | Professional | 53 · Discontinued | $25.70 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $131.83 Typical High $158.49 | Professional | 54 · Surgery only | $95.50 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $26.30 Typical High $31.62 | Professional | 55 · Aftercare only | $19.05 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $17.78 Typical High $20.89 | Professional | 56 · Pre-op care only | $12.88 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $123.03 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $89.13 | $123.03 | $147.91 |
Where California sits
The same service costs 3.4 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
$209
AK $603KY $178
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.