How much rates vary
Facilitymedian $1,698 · 10th to 90th $550 to $8,913Professionalmedian $646 · 10th to 90th $468 to $2,291
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 $741.31 Median $6,606.93 Typical High $15,848.93 | Facility | None | $741.31 | $6,606.93 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $1,202.26 | Professional | None | $524.81 | $645.65 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $8,128.31 Typical High $16,982.44 | Facility | None | $3,890.45 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $1,778.28 | Professional | None | $467.74 | $562.34 | $1,778.28 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,737.80 Typical High $7,585.78 | Facility | None | $100.00 | $1,737.80 | $7,585.78 |
Blue Shield Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $891.25 | Professional | None | $389.05 | $562.34 | $891.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $302.00 Median $549.54 Typical High $1,023.29 | Professional | None | $302.00 | $549.54 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $3,467.37 | Facility | None | $645.65 | $1,778.28 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,096.48 | Professional | None | $549.54 | $691.83 | $1,096.48 |
Contra Costa Health Setting Professional Modifier None Typical Low $251.19 Median $660.69 Typical High $1,000.00 | Professional | None | $251.19 | $660.69 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,698.24 | Professional | None | $524.81 | $794.33 | $1,698.24 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,165.95 | Professional | None | $5,128.61 | $5,128.61 | $6,165.95 |
Molina Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,000.00 | Professional | None | $602.56 | $602.56 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $645.65 Median $1,698.24 Typical High $4,168.69 | Facility | None | $645.65 | $1,698.24 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,096.48 | Professional | None | $549.54 | $691.83 | $1,096.48 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,862.09 | $1,862.09 | $2,290.87 |
United Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $4,466.84 | Facility | None | $549.54 | $549.54 | $4,466.84 |
United Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $1,202.26 | Professional | None | $436.52 | $616.60 | $1,202.26 |
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 $263.03 Median $281.84 Typical High $354.81 | Facility | 52 · Reduced service | $263.03 | $281.84 | $354.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $104.71 Median $112.20 Typical High $141.25 | Facility | 53 · Discontinued | $104.71 | $112.20 | $141.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $398.11 Median $426.58 Typical High $524.81 | Facility | 54 · Surgery only | $398.11 | $426.58 | $524.81 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $79.43 Median $85.11 Typical High $104.71 | Facility | 55 · Aftercare only | $79.43 | $85.11 | $104.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $52.48 Median $56.23 Typical High $70.79 | Facility | 56 · Pre-op care only | $52.48 | $56.23 | $70.79 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $398.11 Typical High $489.78 | Facility | 78 · Unplanned return to OR | $371.54 | $398.11 | $489.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $281.84 Typical High $354.81 | Professional | 52 · Reduced service | $245.47 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $141.25 | Professional | 53 · Discontinued | $100.00 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $426.58 Typical High $524.81 | Professional | 54 · Surgery only | $371.54 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $85.11 Typical High $104.71 | Professional | 55 · Aftercare only | $74.13 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $56.23 Typical High $70.79 | Professional | 56 · Pre-op care only | $50.12 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $398.11 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $346.74 | $398.11 | $489.78 |
Where California sits
The same service costs 4.3 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· 41st of 51
$646
AK $2,291TX $537
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.