How much rates vary
Facilitymedian $1,349 · 10th to 90th $589 to $7,244Professionalmedian $295 · 10th to 90th $195 to $1,096
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 $645.65 Median $5,888.44 Typical High $15,848.93 | Facility | None | $645.65 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $512.86 | Professional | None | $213.80 | $309.03 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
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 $190.55 Median $269.15 Typical High $851.14 | Professional | None | $190.55 | $269.15 | $851.14 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,584.89 Typical High $6,309.57 | Facility | None | $100.00 | $1,584.89 | $6,309.57 |
Blue Shield Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $380.19 | Professional | None | $147.91 | $213.80 | $380.19 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $478.63 | Professional | None | $213.80 | $346.74 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $2,454.71 | Facility | None | $575.44 | $1,174.90 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $512.86 | Professional | None | $218.78 | $309.03 | $512.86 |
Contra Costa Health Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $467.74 | Professional | None | $208.93 | $257.04 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $371.54 Typical High $660.69 | Professional | None | $208.93 | $371.54 | $660.69 |
Lucent Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,951.21 | Professional | None | $2,454.71 | $2,454.71 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $478.63 | Professional | None | $288.40 | $288.40 | $478.63 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $1,148.15 Typical High $3,801.89 | Facility | None | $426.58 | $1,148.15 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $512.86 | Professional | None | $218.78 | $309.03 | $512.86 |
Sutter Health Plus Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,122.02 | Professional | None | $776.25 | $776.25 | $1,122.02 |
United Setting Facility Modifier None Typical Low $691.83 Median $933.25 Typical High $4,466.84 | Facility | None | $691.83 | $933.25 | $4,466.84 |
United Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $575.44 | Professional | None | $186.21 | $281.84 | $575.44 |
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 $107.15 Median $112.20 Typical High $165.96 | Facility | 52 · Reduced service | $107.15 | $112.20 | $165.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $45.71 Typical High $66.07 | Facility | 53 · Discontinued | $42.66 | $45.71 | $66.07 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $162.18 Median $169.82 Typical High $251.19 | Facility | 54 · Surgery only | $162.18 | $169.82 | $251.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $32.36 Median $33.88 Typical High $50.12 | Facility | 55 · Aftercare only | $32.36 | $33.88 | $50.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.91 Typical High $33.11 | Facility | 56 · Pre-op care only | $21.38 | $22.91 | $33.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $158.49 Typical High $234.42 | Facility | 78 · Unplanned return to OR | $151.36 | $158.49 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $131.83 Typical High $154.88 | Professional | 52 · Reduced service | $102.33 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $52.48 Typical High $61.66 | Professional | 53 · Discontinued | $40.74 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $194.98 Typical High $229.09 | Professional | 54 · Surgery only | $154.88 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $38.90 Typical High $45.71 | Professional | 55 · Aftercare only | $30.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $26.30 Typical High $30.90 | Professional | 56 · Pre-op care only | $20.42 | $26.30 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $181.97 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $144.54 | $181.97 | $213.80 |
Where California sits
The same service costs 4.0 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· 44th of 51
$309
AK $1,072KY $269
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.