How much rates vary
Facilitymedian $1,047 · 10th to 90th $100 to $6,761Professionalmedian $151 · 10th to 90th $100 to $490
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 $102.33 Median $151.36 Typical High $295.12 | Professional | None | $102.33 | $151.36 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
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 $102.33 Median $151.36 Typical High $407.38 | Professional | None | $102.33 | $151.36 | $407.38 |
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 $74.13 Median $112.20 Typical High $199.53 | Professional | None | $74.13 | $112.20 | $199.53 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $72.44 Median $123.03 Typical High $251.19 | Professional | None | $72.44 | $123.03 | $251.19 |
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 $107.15 Median $154.88 Typical High $275.42 | Professional | None | $107.15 | $154.88 | $275.42 |
Contra Costa Health Setting Professional Modifier None Typical Low $60.26 Median $120.23 Typical High $245.47 | Professional | None | $60.26 | $120.23 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $186.21 Typical High $346.74 | Professional | None | $97.72 | $186.21 | $346.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,479.11 | Professional | None | $1,288.25 | $1,288.25 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $251.19 | Professional | None | $151.36 | $151.36 | $251.19 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $141.25 Typical High $676.08 | Facility | None | $50.12 | $141.25 | $676.08 |
Providence Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $269.15 | Professional | None | $107.15 | $151.36 | $269.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $588.84 | Professional | None | $363.08 | $363.08 | $588.84 |
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 $89.13 Median $144.54 Typical High $309.03 | Professional | None | $89.13 | $144.54 | $309.03 |
13 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 $53.70 Median $57.54 Typical High $89.13 | Facility | 52 · Reduced service | $53.70 | $57.54 | $89.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.38 Median $22.91 Typical High $35.48 | Facility | 53 · Discontinued | $21.38 | $22.91 | $35.48 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $81.28 Median $85.11 Typical High $134.90 | Facility | 54 · Surgery only | $81.28 | $85.11 | $134.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $17.38 Typical High $26.92 | Facility | 55 · Aftercare only | $16.22 | $17.38 | $26.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.48 Typical High $17.78 | Facility | 56 · Pre-op care only | $10.72 | $11.48 | $17.78 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $79.43 Typical High $125.89 | Facility | 78 · Unplanned return to OR | $75.86 | $79.43 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $67.61 Typical High $81.28 | Professional | 52 · Reduced service | $50.12 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.92 Typical High $32.36 | Professional | 53 · Discontinued | $20.42 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $100.00 Typical High $123.03 | Professional | 54 · Surgery only | $75.86 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $20.42 Typical High $24.55 | Professional | 55 · Aftercare only | $15.14 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.49 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.23 | $13.49 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $93.33 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $70.79 | $93.33 | $114.82 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 51 · Multiple procedures | $104.71 | $104.71 | $104.71 |
Where California sits
The same service costs 3.4 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· 42nd of 51
$155
AK $447KY $132
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.