How much rates vary
Facilitymedian $2,138 · 10th to 90th $676 to $9,333Professionalmedian $955 · 10th to 90th $692 to $3,311
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 $1,023.29 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,023.29 | $6,606.93 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,659.59 | Professional | None | $758.58 | $954.99 | $1,659.59 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $954.99 | Professional | None | $676.08 | $676.08 | $954.99 |
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 $691.83 Median $831.76 Typical High $2,570.40 | Professional | None | $691.83 | $831.76 | $2,570.40 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,737.80 Typical High $7,079.46 | Facility | None | $100.00 | $1,737.80 | $7,079.46 |
Blue Shield Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,380.38 | Professional | None | $630.96 | $912.01 | $1,380.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,412.54 | Professional | None | $758.58 | $1,122.02 | $1,412.54 |
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 $831.76 Median $1,023.29 Typical High $1,584.89 | Professional | None | $831.76 | $1,023.29 | $1,584.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,380.38 | Professional | None | $741.31 | $954.99 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $2,290.87 | Professional | None | $724.44 | $1,096.48 | $2,290.87 |
Lucent Health Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $8,511.38 | Professional | None | $7,244.36 | $7,244.36 | $8,511.38 |
Molina 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 |
Providence Setting Facility Modifier None Typical Low $724.44 Median $1,737.80 Typical High $4,168.69 | Facility | None | $724.44 | $1,737.80 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,584.89 | Professional | None | $831.76 | $1,023.29 | $1,584.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,311.31 | Professional | None | $2,691.53 | $2,691.53 | $3,311.31 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,737.80 | Professional | None | $645.65 | $912.01 | $1,737.80 |
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 $389.05 Median $416.87 Typical High $512.86 | Facility | 52 · Reduced service | $389.05 | $416.87 | $512.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $204.17 | Facility | 53 · Discontinued | $154.88 | $165.96 | $204.17 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $588.84 Median $630.96 Typical High $776.25 | Facility | 54 · Surgery only | $588.84 | $630.96 | $776.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $117.49 Median $125.89 Typical High $154.88 | Facility | 55 · Aftercare only | $117.49 | $125.89 | $154.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $102.33 | Facility | 56 · Pre-op care only | $77.62 | $83.18 | $102.33 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $588.84 Typical High $724.44 | Facility | 78 · Unplanned return to OR | $549.54 | $588.84 | $724.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $416.87 Typical High $512.86 | Professional | 52 · Reduced service | $363.08 | $416.87 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $204.17 | Professional | 53 · Discontinued | $147.91 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $630.96 Typical High $776.25 | Professional | 54 · Surgery only | $549.54 | $630.96 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $125.89 Typical High $154.88 | Professional | 55 · Aftercare only | $109.65 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $83.18 Typical High $102.33 | Professional | 56 · Pre-op care only | $74.13 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $588.84 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $512.86 | $588.84 | $724.44 |
Where California sits
The same service costs 4.5 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· 38th of 51
$977
AK $3,311TX $741
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.