How much rates vary
Facilitymedian $851 · 10th to 90th $129 to $6,310Professionalmedian $229 · 10th to 90th $148 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 $275.42 Median $4,570.88 Typical High $15,135.61 | Facility | None | $275.42 | $4,570.88 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $478.63 | Professional | None | $162.18 | $239.88 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $316.23 Typical High $316.23 | Professional | None | $134.90 | $316.23 | $316.23 |
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 $147.91 Median $213.80 Typical High $630.96 | Professional | None | $147.91 | $213.80 | $630.96 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,148.15 Typical High $4,786.30 | Facility | None | $100.00 | $1,148.15 | $4,786.30 |
Blue Shield Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $316.23 | Professional | None | $114.82 | $169.82 | $316.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $407.38 | Professional | None | $112.20 | $199.53 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $316.23 Typical High $660.69 | Facility | None | $53.70 | $316.23 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $416.87 | Professional | None | $165.96 | $245.47 | $416.87 |
Contra Costa Health Setting Professional Modifier None Typical Low $93.33 Median $194.98 Typical High $398.11 | Professional | None | $93.33 | $194.98 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $302.00 Typical High $562.34 | Professional | None | $154.88 | $302.00 | $562.34 |
Lucent Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,454.71 | Professional | None | $2,041.74 | $2,041.74 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $398.11 | Professional | None | $234.42 | $234.42 | $398.11 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $323.59 Typical High $676.08 | Facility | None | $66.07 | $323.59 | $676.08 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $416.87 | Professional | None | $165.96 | $245.47 | $416.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $912.01 | Professional | None | $549.54 | $549.54 | $912.01 |
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 $131.83 Median $223.87 Typical High $478.63 | Professional | None | $131.83 | $223.87 | $478.63 |
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 $83.18 Median $89.13 Typical High $138.04 | Facility | 52 · Reduced service | $83.18 | $89.13 | $138.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.11 Median $35.48 Typical High $54.95 | Facility | 53 · Discontinued | $33.11 | $35.48 | $54.95 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $123.03 Median $131.83 Typical High $204.17 | Facility | 54 · Surgery only | $123.03 | $131.83 | $204.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.12 Median $26.30 Typical High $40.74 | Facility | 55 · Aftercare only | $25.12 | $26.30 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.60 Median $17.78 Typical High $27.54 | Facility | 56 · Pre-op care only | $16.60 | $17.78 | $27.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $123.03 Typical High $190.55 | Facility | 78 · Unplanned return to OR | $114.82 | $123.03 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $102.33 Typical High $125.89 | Professional | 52 · Reduced service | $77.62 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $40.74 Typical High $50.12 | Professional | 53 · Discontinued | $30.90 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $117.49 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $23.44 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.42 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.49 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $144.54 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $109.65 | $144.54 | $173.78 |
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
$240
AK $692KY $204
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.