How much rates vary
Facilitymedian $2,138 · 10th to 90th $646 to $9,550Professionalmedian $741 · 10th to 90th $550 to $2,818
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 $794.33 Median $6,606.93 Typical High $15,848.93 | Facility | None | $794.33 | $6,606.93 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,318.26 | Professional | None | $602.56 | $741.31 | $1,318.26 |
Ambetter Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
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 $537.03 Median $645.65 Typical High $1,949.84 | Professional | None | $537.03 | $645.65 | $1,949.84 |
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 $467.74 Median $660.69 Typical High $1,071.52 | Professional | None | $467.74 | $660.69 | $1,071.52 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $1,096.48 | Professional | None | $478.63 | $741.31 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $3,630.78 | Facility | None | $645.65 | $1,778.28 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,230.27 | Professional | None | $630.96 | $794.33 | $1,230.27 |
Contra Costa Health Setting Professional Modifier None Typical Low $316.23 Median $724.44 Typical High $1,096.48 | Professional | None | $316.23 | $724.44 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,862.09 | Professional | None | $588.84 | $870.96 | $1,862.09 |
Lucent Health Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $6,760.83 | Professional | None | $5,754.40 | $5,754.40 | $6,760.83 |
Molina Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,096.48 | Professional | None | $660.69 | $660.69 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $1,698.24 Typical High $4,677.35 | Facility | None | $707.95 | $1,698.24 | $4,677.35 |
Providence Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,230.27 | Professional | None | $630.96 | $794.33 | $1,230.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,630.27 | Professional | None | $2,187.76 | $2,187.76 | $2,630.27 |
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 $512.86 Median $707.95 Typical High $1,380.38 | Professional | None | $512.86 | $707.95 | $1,380.38 |
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 $309.03 Median $323.59 Typical High $398.11 | Facility | 52 · Reduced service | $309.03 | $323.59 | $398.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $123.03 Median $131.83 Typical High $158.49 | Facility | 53 · Discontinued | $123.03 | $131.83 | $158.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $457.09 Median $489.78 Typical High $602.56 | Facility | 54 · Surgery only | $457.09 | $489.78 | $602.56 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $91.20 Median $97.72 Typical High $120.23 | Facility | 55 · Aftercare only | $91.20 | $97.72 | $120.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $61.66 Median $66.07 Typical High $79.43 | Facility | 56 · Pre-op care only | $61.66 | $66.07 | $79.43 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $457.09 Typical High $562.34 | Facility | 78 · Unplanned return to OR | $426.58 | $457.09 | $562.34 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $323.59 Typical High $398.11 | Professional | 52 · Reduced service | $288.40 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $131.83 Typical High $158.49 | Professional | 53 · Discontinued | $114.82 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $489.78 Typical High $602.56 | Professional | 54 · Surgery only | $436.52 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $120.23 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $66.07 Typical High $79.43 | Professional | 56 · Pre-op care only | $57.54 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $457.09 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $407.38 | $457.09 | $562.34 |
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· 37th of 51
$759
AK $2,630TX $589
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.