How much rates vary
Facilitymedian $794 · 10th to 90th $120 to $6,310Professionalmedian $182 · 10th to 90th $126 to $676
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 $125.89 Median $181.97 Typical High $269.15 | Professional | None | $125.89 | $181.97 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | None | $190.55 | $190.55 | $199.53 |
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 $128.82 Median $177.83 Typical High $512.86 | Professional | None | $128.82 | $177.83 | $512.86 |
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 $93.33 Median $138.04 Typical High $239.88 | Professional | None | $93.33 | $138.04 | $239.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $288.40 | Professional | None | $100.00 | $147.91 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $177.83 Typical High $371.54 | Facility | None | $53.70 | $177.83 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $316.23 | Professional | None | $131.83 | $186.21 | $316.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $79.43 Median $144.54 Typical High $281.84 | Professional | None | $79.43 | $144.54 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $218.78 Typical High $389.05 | Professional | None | $117.49 | $218.78 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,479.11 | $1,479.11 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $288.40 | Professional | None | $173.78 | $173.78 | $288.40 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $186.21 Typical High $371.54 | Facility | None | $58.88 | $186.21 | $371.54 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $316.23 | Professional | None | $131.83 | $181.97 | $316.23 |
Sutter Health Plus Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $676.08 | Professional | None | $457.09 | $457.09 | $676.08 |
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 $112.20 Median $173.78 Typical High $354.81 | Professional | None | $112.20 | $173.78 | $354.81 |
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 $66.07 Median $70.79 Typical High $104.71 | Facility | 52 · Reduced service | $66.07 | $70.79 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.92 Median $28.18 Typical High $41.69 | Facility | 53 · Discontinued | $26.92 | $28.18 | $41.69 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $100.00 Median $107.15 Typical High $154.88 | Facility | 54 · Surgery only | $100.00 | $107.15 | $154.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.95 Median $21.38 Typical High $31.62 | Facility | 55 · Aftercare only | $19.95 | $21.38 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.13 Typical High $20.89 | Facility | 56 · Pre-op care only | $13.18 | $14.13 | $20.89 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $100.00 Typical High $144.54 | Facility | 78 · Unplanned return to OR | $93.33 | $100.00 | $144.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $79.43 Typical High $95.50 | Professional | 52 · Reduced service | $63.10 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $31.62 Typical High $38.02 | Professional | 53 · Discontinued | $25.12 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $120.23 Typical High $144.54 | Professional | 54 · Surgery only | $93.33 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $23.99 Typical High $28.84 | Professional | 55 · Aftercare only | $18.62 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.85 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.59 | $15.85 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $112.20 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $87.10 | $112.20 | $134.90 |
Where California sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$186
AK $550MD $155
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.