How much rates vary
Facilitymedian $851 · 10th to 90th $166 to $6,310Professionalmedian $214 · 10th to 90th $155 to $933
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 $147.91 Median $213.80 Typical High $288.40 | Professional | None | $147.91 | $213.80 | $288.40 |
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 $154.88 Median $213.80 Typical High $616.60 | Professional | None | $154.88 | $213.80 | $616.60 |
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 $114.82 Median $169.82 Typical High $288.40 | Professional | None | $114.82 | $169.82 | $288.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $338.84 | Professional | None | $120.23 | $177.83 | $338.84 |
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 $162.18 Median $229.09 Typical High $380.19 | Professional | None | $162.18 | $229.09 | $380.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $100.00 Median $177.83 Typical High $331.13 | Professional | None | $100.00 | $177.83 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $257.04 Typical High $467.74 | Professional | None | $144.54 | $257.04 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,041.74 | Professional | None | $1,778.28 | $1,778.28 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $346.74 | Professional | None | $204.17 | $204.17 | $346.74 |
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 $162.18 Median $223.87 Typical High $380.19 | Professional | None | $162.18 | $223.87 | $380.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $812.83 | Professional | None | $562.34 | $562.34 | $812.83 |
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 $138.04 Median $208.93 Typical High $426.58 | Professional | None | $138.04 | $208.93 | $426.58 |
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 $81.28 Median $85.11 Typical High $123.03 | Facility | 52 · Reduced service | $81.28 | $85.11 | $123.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $32.36 Median $34.67 Typical High $48.98 | Facility | 53 · Discontinued | $32.36 | $34.67 | $48.98 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $120.23 Median $128.82 Typical High $186.21 | Facility | 54 · Surgery only | $120.23 | $128.82 | $186.21 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $24.55 Median $25.70 Typical High $37.15 | Facility | 55 · Aftercare only | $24.55 | $25.70 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.38 Typical High $24.55 | Facility | 56 · Pre-op care only | $16.22 | $17.38 | $24.55 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $120.23 Typical High $173.78 | Facility | 78 · Unplanned return to OR | $112.20 | $120.23 | $173.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $97.72 Typical High $114.82 | Professional | 52 · Reduced service | $75.86 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $38.90 Typical High $45.71 | Professional | 53 · Discontinued | $30.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $144.54 Typical High $169.82 | Professional | 54 · Surgery only | $114.82 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $29.51 Typical High $33.88 | Professional | 55 · Aftercare only | $22.91 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.50 Typical High $22.91 | Professional | 56 · Pre-op care only | $15.14 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $134.90 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $107.15 | $134.90 | $158.49 |
Where California sits
The same service costs 3.5 times more in Alaska than in Texas. 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· 38th of 51
$224
AK $676TX $191
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.