How much rates vary
Facilitymedian $891 · 10th to 90th $120 to $6,310Professionalmedian $174 · 10th to 90th $107 to $646
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 $218.78 Median $4,897.79 Typical High $15,135.61 | Facility | None | $218.78 | $4,897.79 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $269.15 | Professional | None | $112.20 | $181.97 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $281.84 | Professional | None | $97.72 | $97.72 | $281.84 |
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 $104.71 Median $165.96 Typical High $457.09 | Professional | None | $104.71 | $165.96 | $457.09 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,174.90 Typical High $4,786.30 | Facility | None | $100.00 | $1,174.90 | $4,786.30 |
Blue Shield Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $245.47 | Professional | None | $102.33 | $147.91 | $245.47 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $269.15 | Professional | None | $112.20 | $144.54 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $204.17 Typical High $426.58 | Facility | None | $53.70 | $204.17 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $295.12 | Professional | None | $125.89 | $186.21 | $295.12 |
Contra Costa Health Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $263.03 | Professional | None | $100.00 | $134.90 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $380.19 | Professional | None | $107.15 | $204.17 | $380.19 |
Lucent Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,318.26 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $257.04 | Professional | None | $154.88 | $154.88 | $257.04 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $208.93 Typical High $467.74 | Facility | None | $61.66 | $208.93 | $467.74 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $288.40 | Professional | None | $125.89 | $186.21 | $288.40 |
Sutter Health Plus Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $645.65 | Professional | None | $371.54 | $371.54 | $645.65 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,090.30 | Facility | None | $123.03 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $338.84 | Professional | None | $91.20 | $162.18 | $338.84 |
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 $60.26 Median $63.10 Typical High $107.15 | Facility | 52 · Reduced service | $60.26 | $63.10 | $107.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $25.12 Typical High $43.65 | Facility | 53 · Discontinued | $23.99 | $25.12 | $43.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $89.13 Median $93.33 Typical High $162.18 | Facility | 54 · Surgery only | $89.13 | $93.33 | $162.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $18.62 Typical High $32.36 | Facility | 55 · Aftercare only | $17.78 | $18.62 | $32.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $21.88 | Facility | 56 · Pre-op care only | $12.02 | $12.59 | $21.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $87.10 Typical High $151.36 | Facility | 78 · Unplanned return to OR | $83.18 | $87.10 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $72.44 Typical High $100.00 | Professional | 52 · Reduced service | $54.95 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $28.84 Typical High $39.81 | Professional | 53 · Discontinued | $22.39 | $28.84 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $109.65 Typical High $151.36 | Professional | 54 · Surgery only | $83.18 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $21.88 Typical High $30.20 | Professional | 55 · Aftercare only | $16.60 | $21.88 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.45 Typical High $19.95 | Professional | 56 · Pre-op care only | $11.22 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $102.33 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $77.62 | $102.33 | $141.25 |
Where California sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 32nd of 51
$182
AK $490FL $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.