How much rates vary
Facilitymedian $589 · 10th to 90th $95 to $6,310Professionalmedian $200 · 10th to 90th $115 to $1,122
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 $229.09 Median $7,079.46 Typical High $18,197.01 | Facility | None | $229.09 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $229.09 | Professional | None | $117.49 | $190.55 | $229.09 |
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 $112.20 Median $194.98 Typical High $549.54 | Professional | None | $112.20 | $194.98 | $549.54 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $416.87 Typical High $1,479.11 | Facility | None | $95.50 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $281.84 | Professional | None | $97.72 | $154.88 | $281.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $77.62 Median $138.04 Typical High $338.84 | Professional | None | $77.62 | $138.04 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $676.08 | Facility | None | $50.12 | $61.66 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $363.08 | Professional | None | $134.90 | $218.78 | $363.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $64.57 Median $154.88 Typical High $331.13 | Professional | None | $64.57 | $154.88 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $257.04 Typical High $457.09 | Professional | None | $123.03 | $257.04 | $457.09 |
Lucent Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,659.59 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $323.59 | Professional | None | $190.55 | $190.55 | $323.59 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $165.96 Typical High $676.08 | Facility | None | $50.12 | $165.96 | $676.08 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $354.81 | Professional | None | $128.82 | $218.78 | $354.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $812.83 | Professional | None | $436.52 | $436.52 | $812.83 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $104.71 Median $199.53 Typical High $416.87 | Professional | None | $104.71 | $199.53 | $416.87 |
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 $63.10 Median $66.07 Typical High $125.89 | Facility | 52 · Reduced service | $63.10 | $66.07 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $26.30 Typical High $50.12 | Facility | 53 · Discontinued | $25.12 | $26.30 | $50.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $93.33 Median $100.00 Typical High $186.21 | Facility | 54 · Surgery only | $93.33 | $100.00 | $186.21 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $19.95 Typical High $37.15 | Facility | 55 · Aftercare only | $18.62 | $19.95 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.18 Typical High $25.12 | Facility | 56 · Pre-op care only | $12.59 | $13.18 | $25.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $93.33 Typical High $173.78 | Facility | 78 · Unplanned return to OR | $87.10 | $93.33 | $173.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $91.20 Typical High $112.20 | Professional | 52 · Reduced service | $58.88 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $36.31 Typical High $45.71 | Professional | 53 · Discontinued | $23.44 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $134.90 Typical High $169.82 | Professional | 54 · Surgery only | $89.13 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $26.92 Typical High $33.88 | Professional | 55 · Aftercare only | $17.78 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $18.20 Typical High $22.91 | Professional | 56 · Pre-op care only | $11.75 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $125.89 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $83.18 | $125.89 | $158.49 |
Where California sits
The same service costs 3.8 times more in Alaska than in Maryland. 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· 31st of 51
$209
AK $603MD $158
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.