How much rates vary
Facilitymedian $562 · 10th to 90th $195 to $5,495Professionalmedian $427 · 10th to 90th $302 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 $457.09 Median $7,079.46 Typical High $18,197.01 | Facility | None | $457.09 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $457.09 | Professional | None | $323.59 | $389.05 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $1,148.15 | Professional | None | $302.00 | $398.11 | $1,148.15 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $426.58 Typical High $1,479.11 | Facility | None | $97.72 | $426.58 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $616.60 | Professional | None | $251.19 | $363.08 | $616.60 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $223.87 Median $416.87 Typical High $630.96 | Professional | None | $223.87 | $416.87 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $426.58 Typical High $870.96 | Facility | None | $302.00 | $426.58 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $741.31 | Professional | None | $354.81 | $478.63 | $741.31 |
Contra Costa Health Setting Professional Modifier None Typical Low $151.36 Median $407.38 Typical High $616.60 | Professional | None | $151.36 | $407.38 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $1,047.13 | Professional | None | $323.59 | $489.78 | $1,047.13 |
Lucent Health Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,801.89 | Professional | None | $3,311.31 | $3,311.31 | $3,801.89 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $489.78 Typical High $2,570.40 | Facility | None | $309.03 | $489.78 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $741.31 | Professional | None | $354.81 | $457.09 | $741.31 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,174.90 | $1,548.82 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,090.30 | Facility | None | $123.03 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $812.83 | Professional | None | $281.84 | $407.38 | $812.83 |
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 $173.78 Median $186.21 Typical High $251.19 | Facility | 52 · Reduced service | $173.78 | $186.21 | $251.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $69.18 Median $75.86 Typical High $100.00 | Facility | 53 · Discontinued | $69.18 | $75.86 | $100.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $263.03 Median $281.84 Typical High $380.19 | Facility | 54 · Surgery only | $263.03 | $281.84 | $380.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $52.48 Median $56.23 Typical High $75.86 | Facility | 55 · Aftercare only | $52.48 | $56.23 | $75.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.02 Typical High $50.12 | Facility | 56 · Pre-op care only | $34.67 | $38.02 | $50.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $263.03 Typical High $354.81 | Facility | 78 · Unplanned return to OR | $245.47 | $263.03 | $354.81 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $190.55 Typical High $229.09 | Professional | 52 · Reduced service | $162.18 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $75.86 Typical High $91.20 | Professional | 53 · Discontinued | $64.57 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $281.84 Typical High $338.84 | Professional | 54 · Surgery only | $245.47 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $56.23 Typical High $69.18 | Professional | 55 · Aftercare only | $48.98 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $38.02 Typical High $45.71 | Professional | 56 · Pre-op care only | $32.36 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $263.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $229.09 | $263.03 | $316.23 |
Where California sits
The same service costs 6.0 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· 33rd of 51
$437
AK $1,445TX $240
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.