How much rates vary
Facilitymedian $631 · 10th to 90th $162 to $4,677Professionalmedian $178 · 10th to 90th $120 to $501
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 $208.93 Median $4,897.79 Typical High $15,135.61 | Facility | None | $208.93 | $4,897.79 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $281.84 | Professional | None | $141.25 | $186.21 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $177.83 | Professional | None | $123.03 | $141.25 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $436.52 | Professional | None | $141.25 | $173.78 | $436.52 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,445.44 Typical High $4,897.79 | Facility | None | $100.00 | $1,445.44 | $4,897.79 |
Blue Shield Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $251.19 | Professional | None | $109.65 | $154.88 | $251.19 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $223.87 | Professional | None | $100.00 | $125.89 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $218.78 Typical High $1,047.13 | Facility | None | $138.04 | $218.78 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $263.03 | Professional | None | $151.36 | $194.98 | $263.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $223.87 | Professional | None | $85.11 | $123.03 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $177.83 Typical High $316.23 | Professional | None | $97.72 | $177.83 | $316.23 |
Lucent Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,348.96 | Professional | None | $1,174.90 | $1,174.90 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $223.87 | Professional | None | $134.90 | $134.90 | $223.87 |
Providence Setting Facility Modifier None Typical Low $138.04 Median $281.84 Typical High $2,454.71 | Facility | None | $138.04 | $281.84 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $257.04 | Professional | None | $151.36 | $194.98 | $257.04 |
Sutter Health Plus Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $524.81 | Professional | None | $338.84 | $338.84 | $524.81 |
United Setting Facility Modifier None Typical Low $257.04 Median $446.68 Typical High $741.31 | Facility | None | $257.04 | $446.68 | $741.31 |
United Setting Professional Modifier None Typical Low $83.18 Median $151.36 Typical High $288.40 | Professional | None | $83.18 | $151.36 | $288.40 |
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 $77.62 Median $81.28 Typical High $104.71 | Facility | 52 · Reduced service | $77.62 | $81.28 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $31.62 Median $33.11 Typical High $42.66 | Facility | 53 · Discontinued | $31.62 | $33.11 | $42.66 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $123.03 Typical High $158.49 | Facility | 54 · Surgery only | $117.49 | $123.03 | $158.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $24.55 Typical High $31.62 | Facility | 55 · Aftercare only | $23.44 | $24.55 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.22 Typical High $20.89 | Facility | 56 · Pre-op care only | $15.85 | $16.22 | $20.89 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $114.82 Typical High $147.91 | Facility | 78 · Unplanned return to OR | $109.65 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $81.28 Typical High $100.00 | Professional | 52 · Reduced service | $69.18 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $28.18 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $123.03 Typical High $147.91 | Professional | 54 · Surgery only | $104.71 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $29.51 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.22 Typical High $19.95 | Professional | 56 · Pre-op care only | $14.13 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $114.82 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $97.72 | $114.82 | $138.04 |
Where California sits
The same service costs 3.2 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· 23rd of 51
$191
AK $427TX $132
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.