How much rates vary
Facilitymedian $1,288 · 10th to 90th $389 to $6,310Professionalmedian $513 · 10th to 90th $339 to $2,754
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 $7,079.46 Typical High $18,197.01 | Facility | None | $524.81 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $549.54 | Professional | None | $346.74 | $436.52 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $2,137.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $1,230.27 | Professional | None | $338.84 | $467.74 | $1,230.27 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,513.56 Typical High $5,128.61 | Facility | None | $100.00 | $1,513.56 | $5,128.61 |
Blue Shield Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $794.33 | Professional | None | $323.59 | $478.63 | $794.33 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $251.19 Median $436.52 Typical High $691.83 | Professional | None | $251.19 | $436.52 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $549.54 Typical High $1,412.54 | Facility | None | $371.54 | $549.54 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $870.96 | Professional | None | $407.38 | $575.44 | $870.96 |
Contra Costa Health Setting Professional Modifier None Typical Low $169.82 Median $426.58 Typical High $676.08 | Professional | None | $169.82 | $426.58 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $537.03 Typical High $1,071.52 | Professional | None | $338.84 | $537.03 | $1,071.52 |
Lucent Health Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,073.80 | Professional | None | $3,548.13 | $3,548.13 | $4,073.80 |
Molina Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $676.08 | Professional | None | $407.38 | $407.38 | $676.08 |
Providence Setting Facility Modifier None Typical Low $380.19 Median $616.60 Typical High $2,570.40 | Facility | None | $380.19 | $616.60 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $870.96 | Professional | None | $407.38 | $575.44 | $870.96 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,318.26 | $1,819.70 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,230.27 Typical High $4,786.30 | Facility | None | $398.11 | $1,230.27 | $4,786.30 |
United Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $954.99 | Professional | None | $316.23 | $467.74 | $954.99 |
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 $186.21 Median $199.53 Typical High $288.40 | Facility | 52 · Reduced service | $186.21 | $199.53 | $288.40 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $74.13 Median $79.43 Typical High $114.82 | Facility | 53 · Discontinued | $74.13 | $79.43 | $114.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $275.42 Median $302.00 Typical High $436.52 | Facility | 54 · Surgery only | $275.42 | $302.00 | $436.52 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $54.95 Median $60.26 Typical High $87.10 | Facility | 55 · Aftercare only | $54.95 | $60.26 | $87.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $37.15 Median $39.81 Typical High $57.54 | Facility | 56 · Pre-op care only | $37.15 | $39.81 | $57.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $281.84 Typical High $407.38 | Facility | 78 · Unplanned return to OR | $257.04 | $281.84 | $407.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $208.93 Typical High $263.03 | Professional | 52 · Reduced service | $173.78 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $83.18 Typical High $104.71 | Professional | 53 · Discontinued | $69.18 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $316.23 Typical High $389.05 | Professional | 54 · Surgery only | $257.04 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $63.10 Typical High $77.62 | Professional | 55 · Aftercare only | $51.29 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $41.69 Typical High $52.48 | Professional | 56 · Pre-op care only | $34.67 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $295.12 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $239.88 | $295.12 | $363.08 |
Where California sits
The same service costs 5.1 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· 27th of 51
$525
AK $1,514TX $295
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.