How much rates vary
Facilitymedian $661 · 10th to 90th $78 to $6,310Professionalmedian $69 · 10th to 90th $48 to $200
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 $83.18 Median $4,897.79 Typical High $15,135.61 | Facility | None | $83.18 | $4,897.79 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $74.13 Typical High $112.20 | Professional | None | $51.29 | $74.13 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $67.61 Typical High $74.13 | Professional | None | $60.26 | $67.61 | $74.13 |
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 $47.86 Median $69.18 Typical High $177.83 | Professional | None | $47.86 | $69.18 | $177.83 |
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 $35.48 Median $51.29 Typical High $93.33 | Professional | None | $35.48 | $51.29 | $93.33 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $125.89 | Professional | None | $66.07 | $91.20 | $125.89 |
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 $50.12 Median $67.61 Typical High $104.71 | Professional | None | $50.12 | $67.61 | $104.71 |
Contra Costa Health Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $93.33 | Professional | None | $58.88 | $70.79 | $93.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $50.12 Median $74.13 Typical High $165.96 | Professional | None | $50.12 | $74.13 | $165.96 |
Lucent Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $575.44 | Professional | None | $501.19 | $501.19 | $575.44 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $95.50 | Professional | None | $56.23 | $56.23 | $95.50 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $74.13 Typical High $676.08 | Facility | None | $50.12 | $74.13 | $676.08 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $102.33 | Professional | None | $48.98 | $67.61 | $102.33 |
Sutter Health Plus Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Sutter Health Plus Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $213.80 | Professional | None | $177.83 | $177.83 | $213.80 |
United Setting Facility Modifier None Typical Low $123.03 Median $501.19 Typical High $3,090.30 | Facility | None | $123.03 | $501.19 | $3,090.30 |
United Setting Professional Modifier None Typical Low $41.69 Median $60.26 Typical High $123.03 | Professional | None | $41.69 | $60.26 | $123.03 |
15 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 $25.70 Median $28.18 Typical High $41.69 | Facility | 52 · Reduced service | $25.70 | $28.18 | $41.69 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.23 Median $11.22 Typical High $16.98 | Facility | 53 · Discontinued | $10.23 | $11.22 | $16.98 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $38.90 Median $41.69 Typical High $63.10 | Facility | 54 · Surgery only | $38.90 | $41.69 | $63.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.76 Median $8.32 Typical High $12.59 | Facility | 55 · Aftercare only | $7.76 | $8.32 | $12.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.62 Typical High $8.32 | Facility | 56 · Pre-op care only | $5.13 | $5.62 | $8.32 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $36.31 Median $38.90 Typical High $58.88 | Facility | 78 · Unplanned return to OR | $36.31 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $28.18 Typical High $38.02 | Professional | 52 · Reduced service | $23.99 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $11.48 Typical High $15.14 | Professional | 53 · Discontinued | $9.77 | $11.48 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $42.66 Typical High $57.54 | Professional | 54 · Surgery only | $36.31 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.51 Typical High $11.48 | Professional | 55 · Aftercare only | $7.24 | $8.51 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.62 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.79 | $5.62 | $7.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.88 Median $39.81 Typical High $53.70 | Professional | 78 · Unplanned return to OR | $33.88 | $39.81 | $53.70 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $39.81 Median $74.13 Typical High $77.62 | Professional | 51 · Multiple procedures | $39.81 | $74.13 | $77.62 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $63.10 Median $67.61 Typical High $79.43 | Professional | 59 · Distinct service | $63.10 | $67.61 | $79.43 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $67.61 Median $70.79 Typical High $79.43 | Professional | 79 · Unrelated procedure after surgery | $67.61 | $70.79 | $79.43 |
Where California sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 29th of 51
$70.79
AK $224KY $53.70
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.