How much rates vary
Facilitymedian $851 · 10th to 90th $162 to $6,457Professionalmedian $204 · 10th to 90th $138 to $912
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 $645.65 Median $5,888.44 Typical High $15,848.93 | Facility | None | $645.65 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $275.42 | Professional | None | $147.91 | $204.17 | $275.42 |
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 $141.25 Median $204.17 Typical High $575.44 | Professional | None | $141.25 | $204.17 | $575.44 |
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 $102.33 Median $151.36 Typical High $269.15 | Professional | None | $102.33 | $151.36 | $269.15 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $331.13 | Professional | None | $109.65 | $165.96 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $309.03 Typical High $758.58 | Facility | None | $194.98 | $309.03 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $363.08 | Professional | None | $147.91 | $213.80 | $363.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $323.59 | Professional | None | $91.20 | $162.18 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $251.19 Typical High $446.68 | Professional | None | $131.83 | $251.19 | $446.68 |
Lucent Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,698.24 | $1,698.24 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $331.13 | Professional | None | $199.53 | $199.53 | $331.13 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $331.13 Typical High $2,570.40 | Facility | None | $190.55 | $331.13 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $363.08 | Professional | None | $144.54 | $208.93 | $363.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $776.25 | Professional | None | $512.86 | $512.86 | $776.25 |
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 $123.03 Median $194.98 Typical High $407.38 | Professional | None | $123.03 | $194.98 | $407.38 |
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 $74.13 Median $77.62 Typical High $117.49 | Facility | 52 · Reduced service | $74.13 | $77.62 | $117.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $29.51 Median $30.90 Typical High $46.77 | Facility | 53 · Discontinued | $29.51 | $30.90 | $46.77 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $109.65 Median $117.49 Typical High $177.83 | Facility | 54 · Surgery only | $109.65 | $117.49 | $177.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.88 Median $23.44 Typical High $35.48 | Facility | 55 · Aftercare only | $21.88 | $23.44 | $35.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.49 Typical High $23.44 | Facility | 56 · Pre-op care only | $14.79 | $15.49 | $23.44 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $109.65 Typical High $165.96 | Facility | 78 · Unplanned return to OR | $102.33 | $109.65 | $165.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $89.13 Typical High $107.15 | Professional | 52 · Reduced service | $69.18 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $36.31 Typical High $43.65 | Professional | 53 · Discontinued | $27.54 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $134.90 Typical High $162.18 | Professional | 54 · Surgery only | $104.71 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $26.92 Typical High $32.36 | Professional | 55 · Aftercare only | $20.89 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.80 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $125.89 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $97.72 | $125.89 | $151.36 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 79 · Unrelated procedure after surgery | $181.97 | $181.97 | $181.97 |
Where California sits
The same service costs 3.5 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· 40th of 51
$214
AK $617KY $178
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.