How much rates vary
Facilitymedian $1,047 · 10th to 90th $89 to $6,761Professionalmedian $123 · 10th to 90th $79 to $447
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 $79.43 Median $123.03 Typical High $208.93 | Professional | None | $79.43 | $123.03 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
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 $79.43 Median $120.23 Typical High $323.59 | Professional | None | $79.43 | $120.23 | $323.59 |
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 $57.54 Median $89.13 Typical High $158.49 | Professional | None | $57.54 | $89.13 | $158.49 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $52.48 Median $93.33 Typical High $199.53 | Professional | None | $52.48 | $93.33 | $199.53 |
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 $81.28 Median $123.03 Typical High $218.78 | Professional | None | $81.28 | $123.03 | $218.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $43.65 Median $97.72 Typical High $194.98 | Professional | None | $43.65 | $97.72 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $147.91 Typical High $275.42 | Professional | None | $77.62 | $147.91 | $275.42 |
Lucent Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,023.29 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $194.98 | Professional | None | $117.49 | $117.49 | $194.98 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $112.20 Typical High $676.08 | Facility | None | $50.12 | $112.20 | $676.08 |
Providence Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $213.80 | Professional | None | $81.28 | $123.03 | $213.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $457.09 | Professional | None | $288.40 | $288.40 | $457.09 |
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 $69.18 Median $114.82 Typical High $245.47 | Professional | None | $69.18 | $114.82 | $245.47 |
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 $41.69 Median $44.67 Typical High $72.44 | Facility | 52 · Reduced service | $41.69 | $44.67 | $72.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.60 Median $17.78 Typical High $28.84 | Facility | 53 · Discontinued | $16.60 | $17.78 | $28.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $63.10 Median $67.61 Typical High $109.65 | Facility | 54 · Surgery only | $63.10 | $67.61 | $109.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.59 Median $13.49 Typical High $21.88 | Facility | 55 · Aftercare only | $12.59 | $13.49 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.91 Typical High $14.45 | Facility | 56 · Pre-op care only | $8.32 | $8.91 | $14.45 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $63.10 Typical High $102.33 | Facility | 78 · Unplanned return to OR | $58.88 | $63.10 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $53.70 Typical High $66.07 | Professional | 52 · Reduced service | $39.81 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $21.88 Typical High $26.30 | Professional | 53 · Discontinued | $15.85 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $81.28 Typical High $97.72 | Professional | 54 · Surgery only | $58.88 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $16.22 Typical High $19.95 | Professional | 55 · Aftercare only | $11.75 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.96 Typical High $13.18 | Professional | 56 · Pre-op care only | $7.94 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $75.86 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $54.95 | $75.86 | $91.20 |
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
$126
AK $355KY $100
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.