How much rates vary
Facilitymedian $575 · 10th to 90th $200 to $5,623Professionalmedian $324 · 10th to 90th $245 to $1,230
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 $478.63 Median $5,128.61 Typical High $15,135.61 | Facility | None | $478.63 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $549.54 | Professional | None | $251.19 | $316.23 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $239.88 Median $302.00 Typical High $870.96 | Professional | None | $239.88 | $302.00 | $870.96 |
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 $234.42 Median $331.13 Typical High $524.81 | Professional | None | $234.42 | $331.13 | $524.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $478.63 | Professional | None | $223.87 | $316.23 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $398.11 Typical High $851.14 | Facility | None | $281.84 | $398.11 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $549.54 | Professional | None | $275.42 | $346.74 | $549.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $478.63 | Professional | None | $186.21 | $316.23 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $794.33 | Professional | None | $251.19 | $380.19 | $794.33 |
Lucent Health Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,951.21 | Professional | None | $2,511.89 | $2,511.89 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $489.78 | Professional | None | $288.40 | $288.40 | $489.78 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $436.52 Typical High $2,570.40 | Facility | None | $288.40 | $436.52 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $549.54 | Professional | None | $275.42 | $346.74 | $549.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,122.02 | Professional | None | $912.01 | $912.01 | $1,122.02 |
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 $213.80 Median $309.03 Typical High $588.84 | Professional | None | $213.80 | $309.03 | $588.84 |
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 $125.89 Median $134.90 Typical High $173.78 | Facility | 52 · Reduced service | $125.89 | $134.90 | $173.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $51.29 Median $54.95 Typical High $69.18 | Facility | 53 · Discontinued | $51.29 | $54.95 | $69.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $190.55 Median $204.17 Typical High $257.04 | Facility | 54 · Surgery only | $190.55 | $204.17 | $257.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.02 Median $40.74 Typical High $51.29 | Facility | 55 · Aftercare only | $38.02 | $40.74 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.92 Typical High $34.67 | Facility | 56 · Pre-op care only | $25.12 | $26.92 | $34.67 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $190.55 Typical High $239.88 | Facility | 78 · Unplanned return to OR | $177.83 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $138.04 Typical High $158.49 | Professional | 52 · Reduced service | $120.23 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $56.23 Typical High $63.10 | Professional | 53 · Discontinued | $47.86 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $208.93 Typical High $239.88 | Professional | 54 · Surgery only | $177.83 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $41.69 Typical High $47.86 | Professional | 55 · Aftercare only | $35.48 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $27.54 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.99 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $194.98 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $165.96 | $194.98 | $223.87 |
Where California sits
The same service costs 4.7 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· 32nd of 51
$339
AK $1,122TX $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.