How much rates vary
Facilitymedian $776 · 10th to 90th $110 to $6,310Professionalmedian $145 · 10th to 90th $95 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 $95.50 Median $147.91 Typical High $275.42 | Professional | None | $95.50 | $147.91 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
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 $97.72 Median $141.25 Typical High $389.05 | Professional | None | $97.72 | $141.25 | $389.05 |
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 $70.79 Median $104.71 Typical High $186.21 | Professional | None | $70.79 | $104.71 | $186.21 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $234.42 | Professional | None | $67.61 | $117.49 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $173.78 Typical High $363.08 | Facility | None | $53.70 | $173.78 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $257.04 | Professional | None | $102.33 | $147.91 | $257.04 |
Contra Costa Health Setting Professional Modifier None Typical Low $57.54 Median $114.82 Typical High $229.09 | Professional | None | $57.54 | $114.82 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $177.83 Typical High $316.23 | Professional | None | $93.33 | $177.83 | $316.23 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,380.38 | Professional | None | $1,202.26 | $1,202.26 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $234.42 | Professional | None | $141.25 | $141.25 | $234.42 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $173.78 Typical High $354.81 | Facility | None | $58.88 | $173.78 | $354.81 |
Providence Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $251.19 | Professional | None | $102.33 | $144.54 | $251.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $549.54 | Professional | None | $346.74 | $346.74 | $549.54 |
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 $85.11 Median $138.04 Typical High $288.40 | Professional | None | $85.11 | $138.04 | $288.40 |
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 $51.29 Median $54.95 Typical High $83.18 | Facility | 52 · Reduced service | $51.29 | $54.95 | $83.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $21.88 Typical High $33.88 | Facility | 53 · Discontinued | $20.42 | $21.88 | $33.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $77.62 Median $83.18 Typical High $125.89 | Facility | 54 · Surgery only | $77.62 | $83.18 | $125.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.49 Median $16.60 Typical High $25.12 | Facility | 55 · Aftercare only | $15.49 | $16.60 | $25.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.96 Typical High $16.98 | Facility | 56 · Pre-op care only | $10.23 | $10.96 | $16.98 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $77.62 Typical High $117.49 | Facility | 78 · Unplanned return to OR | $72.44 | $77.62 | $117.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $63.10 Typical High $75.86 | Professional | 52 · Reduced service | $47.86 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $25.12 Typical High $30.90 | Professional | 53 · Discontinued | $19.50 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $93.33 Typical High $114.82 | Professional | 54 · Surgery only | $72.44 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $19.05 Typical High $22.91 | Professional | 55 · Aftercare only | $14.45 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $12.59 Typical High $15.49 | Professional | 56 · Pre-op care only | $9.77 | $12.59 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $87.10 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $67.61 | $87.10 | $107.15 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 51 · Multiple procedures | $95.50 | $95.50 | $95.50 |
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
$148
AK $427KY $123
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.