How much rates vary
Facilitymedian $933 · 10th to 90th $282 to $7,586Professionalmedian $380 · 10th to 90th $263 to $1,230
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 $524.81 Median $6,456.54 Typical High $15,848.93 | Facility | None | $524.81 | $6,456.54 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $707.95 | Professional | None | $275.42 | $398.11 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $467.74 | Professional | None | $199.53 | $199.53 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $7,943.28 Typical High $16,982.44 | Facility | None | $3,630.78 | $7,943.28 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $1,023.29 | Professional | None | $263.03 | $354.81 | $1,023.29 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,479.11 Typical High $7,079.46 | Facility | None | $100.00 | $1,479.11 | $7,079.46 |
Blue Shield Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $524.81 | Professional | None | $208.93 | $302.00 | $524.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $602.56 | Professional | None | $204.17 | $275.42 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $478.63 Typical High $1,148.15 | Facility | None | $302.00 | $478.63 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $660.69 | Professional | None | $269.15 | $398.11 | $660.69 |
Contra Costa Health Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $588.84 | Professional | None | $169.82 | $275.42 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $446.68 Typical High $812.83 | Professional | None | $223.87 | $446.68 | $812.83 |
Lucent Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,630.78 | Professional | None | $3,019.95 | $3,019.95 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $588.84 | Professional | None | $354.81 | $354.81 | $588.84 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $537.03 Typical High $3,890.45 | Facility | None | $302.00 | $537.03 | $3,890.45 |
Providence Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $645.65 | Professional | None | $269.15 | $398.11 | $645.65 |
Sutter Health Plus Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,412.54 | Professional | None | $851.14 | $851.14 | $1,412.54 |
United Setting Facility Modifier None Typical Low $194.98 Median $549.54 Typical High $1,096.48 | Facility | None | $194.98 | $549.54 | $1,096.48 |
United Setting Professional Modifier None Typical Low $208.93 Median $354.81 Typical High $758.58 | Professional | None | $208.93 | $354.81 | $758.58 |
13 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 $151.36 Median $158.49 Typical High $223.87 | Facility | 52 · Reduced service | $151.36 | $158.49 | $223.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $60.26 Median $64.57 Typical High $89.13 | Facility | 53 · Discontinued | $60.26 | $64.57 | $89.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $223.87 Median $239.88 Typical High $338.84 | Facility | 54 · Surgery only | $223.87 | $239.88 | $338.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $44.67 Median $47.86 Typical High $67.61 | Facility | 55 · Aftercare only | $44.67 | $47.86 | $67.61 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.20 Median $32.36 Typical High $44.67 | Facility | 56 · Pre-op care only | $30.20 | $32.36 | $44.67 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $223.87 Typical High $316.23 | Facility | 78 · Unplanned return to OR | $208.93 | $223.87 | $316.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $165.96 Typical High $204.17 | Professional | 52 · Reduced service | $141.25 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $66.07 Typical High $83.18 | Professional | 53 · Discontinued | $56.23 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $251.19 Typical High $309.03 | Professional | 54 · Surgery only | $213.80 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $50.12 Typical High $61.66 | Professional | 55 · Aftercare only | $42.66 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $33.11 Typical High $41.69 | Professional | 56 · Pre-op care only | $28.18 | $33.11 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $234.42 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $199.53 | $234.42 | $288.40 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $398.11 Median $446.68 Typical High $446.68 | Professional | 59 · Distinct service | $398.11 | $446.68 | $446.68 |
Where California sits
The same service costs 3.2 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
$398
AK $1,047FL $324
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.