How much rates vary
Facilitymedian $776 · 10th to 90th $100 to $6,310Professionalmedian $129 · 10th to 90th $85 to $537
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 $87.10 Median $125.89 Typical High $177.83 | Professional | None | $87.10 | $125.89 | $177.83 |
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 $87.10 Median $128.82 Typical High $354.81 | Professional | None | $87.10 | $128.82 | $354.81 |
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 $63.10 Median $95.50 Typical High $169.82 | Professional | None | $63.10 | $95.50 | $169.82 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $57.54 Median $102.33 Typical High $213.80 | Professional | None | $57.54 | $102.33 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $158.49 Typical High $331.13 | Facility | None | $53.70 | $158.49 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $229.09 | Professional | None | $91.20 | $134.90 | $229.09 |
Contra Costa Health Setting Professional Modifier None Typical Low $47.86 Median $104.71 Typical High $208.93 | Professional | None | $47.86 | $104.71 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $162.18 Typical High $288.40 | Professional | None | $85.11 | $162.18 | $288.40 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Professional | None | $1,096.48 | $1,096.48 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $208.93 | Professional | None | $125.89 | $125.89 | $208.93 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $158.49 Typical High $331.13 | Facility | None | $58.88 | $158.49 | $331.13 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $229.09 | Professional | None | $91.20 | $131.83 | $229.09 |
Sutter Health Plus Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $489.78 | Professional | None | $316.23 | $316.23 | $489.78 |
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 $75.86 Median $125.89 Typical High $263.03 | Professional | None | $75.86 | $125.89 | $263.03 |
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 $45.71 Median $48.98 Typical High $75.86 | Facility | 52 · Reduced service | $45.71 | $48.98 | $75.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $19.50 Typical High $30.90 | Facility | 53 · Discontinued | $18.20 | $19.50 | $30.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $69.18 Median $74.13 Typical High $114.82 | Facility | 54 · Surgery only | $69.18 | $74.13 | $114.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.80 Median $14.79 Typical High $22.91 | Facility | 55 · Aftercare only | $13.80 | $14.79 | $22.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.77 Typical High $15.49 | Facility | 56 · Pre-op care only | $9.12 | $9.77 | $15.49 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $69.18 Typical High $107.15 | Facility | 78 · Unplanned return to OR | $64.57 | $69.18 | $107.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $43.65 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $22.91 Typical High $28.18 | Professional | 53 · Discontinued | $17.38 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $87.10 Typical High $104.71 | Professional | 54 · Surgery only | $64.57 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $17.38 Typical High $20.89 | Professional | 55 · Aftercare only | $12.88 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.48 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.71 | $11.48 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $81.28 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $60.26 | $81.28 | $97.72 |
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· 39th of 51
$135
AK $389KY $110
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.