How much rates vary
Facilitymedian $1,047 · 10th to 90th $81 to $6,761Professionalmedian $85 · 10th to 90th $60 to $302
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 $61.66 Median $89.13 Typical High $162.18 | Professional | None | $61.66 | $89.13 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
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 $58.88 Median $83.18 Typical High $257.04 | Professional | None | $58.88 | $83.18 | $257.04 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,023.29 Typical High $4,677.35 | Facility | None | $100.00 | $1,023.29 | $4,677.35 |
Blue Shield Setting Professional Modifier None Typical Low $45.71 Median $67.61 Typical High $120.23 | Professional | None | $45.71 | $67.61 | $120.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $138.04 | Professional | None | $44.67 | $79.43 | $138.04 |
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 $64.57 Median $93.33 Typical High $151.36 | Professional | None | $64.57 | $93.33 | $151.36 |
Contra Costa Health Setting Professional Modifier None Typical Low $38.02 Median $77.62 Typical High $138.04 | Professional | None | $38.02 | $77.62 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $109.65 Typical High $199.53 | Professional | None | $61.66 | $109.65 | $199.53 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $831.76 | Professional | None | $724.44 | $724.44 | $831.76 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $141.25 | Professional | None | $83.18 | $83.18 | $141.25 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $83.18 Typical High $676.08 | Facility | None | $50.12 | $83.18 | $676.08 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $151.36 | Professional | None | $64.57 | $93.33 | $151.36 |
Sutter Health Plus Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
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 $53.70 Median $81.28 Typical High $165.96 | Professional | None | $53.70 | $81.28 | $165.96 |
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 $30.90 Median $33.11 Typical High $47.86 | Facility | 52 · Reduced service | $30.90 | $33.11 | $47.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.30 Median $13.18 Typical High $19.50 | Facility | 53 · Discontinued | $12.30 | $13.18 | $19.50 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $46.77 Median $50.12 Typical High $72.44 | Facility | 54 · Surgery only | $46.77 | $50.12 | $72.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.33 Median $10.00 Typical High $14.45 | Facility | 55 · Aftercare only | $9.33 | $10.00 | $14.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.61 Typical High $9.55 | Facility | 56 · Pre-op care only | $6.17 | $6.61 | $9.55 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $43.65 Median $46.77 Typical High $67.61 | Facility | 78 · Unplanned return to OR | $43.65 | $46.77 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $38.02 Typical High $44.67 | Professional | 52 · Reduced service | $30.20 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $15.49 Typical High $17.78 | Professional | 53 · Discontinued | $12.02 | $15.49 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $57.54 Typical High $66.07 | Professional | 54 · Surgery only | $45.71 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $11.48 Typical High $13.18 | Professional | 55 · Aftercare only | $9.12 | $11.48 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.59 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.03 | $7.59 | $8.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $53.70 Typical High $61.66 | Professional | 78 · Unplanned return to OR | $42.66 | $53.70 | $61.66 |
Where California sits
The same service costs 3.8 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· 43rd of 51
$89.13
AK $288KY $75.86
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.