How much rates vary
Facilitymedian $380 · 10th to 90th $52 to $3,548Professionalmedian $48 · 10th to 90th $40 to $234
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 $44.67 Median $7,079.46 Typical High $18,197.01 | Facility | None | $44.67 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $45.71 Typical High $61.66 | Professional | None | $40.74 | $45.71 | $61.66 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.90 Median $51.29 Typical High $3,890.45 | Facility | None | $38.90 | $51.29 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $131.83 | Professional | None | $39.81 | $41.69 | $131.83 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $416.87 Typical High $1,479.11 | Facility | None | $91.20 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $32.36 Median $45.71 Typical High $75.86 | Professional | None | $32.36 | $45.71 | $75.86 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $72.44 | Professional | None | $43.65 | $54.95 | $72.44 |
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 $44.67 Median $51.29 Typical High $83.18 | Professional | None | $44.67 | $51.29 | $83.18 |
Contra Costa Health Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $70.79 | Professional | None | $37.15 | $53.70 | $70.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $57.54 Typical High $131.83 | Professional | None | $43.65 | $57.54 | $131.83 |
Lucent Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | None | $389.05 | $389.05 | $446.68 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $75.86 | Professional | None | $44.67 | $44.67 | $75.86 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $63.10 Typical High $676.08 | Facility | None | $50.12 | $63.10 | $676.08 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $51.29 Typical High $83.18 | Professional | None | $44.67 | $51.29 | $83.18 |
Sutter Health Plus Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | None | $162.18 | $162.18 | $169.82 |
United Setting Facility Modifier None Typical Low $120.23 Median $489.78 Typical High $3,090.30 | Facility | None | $120.23 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $38.02 Median $47.86 Typical High $95.50 | Professional | None | $38.02 | $47.86 | $95.50 |
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 $19.95 Median $22.39 Typical High $23.44 | Facility | 52 · Reduced service | $19.95 | $22.39 | $23.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.13 Median $8.91 Typical High $9.33 | Facility | 53 · Discontinued | $8.13 | $8.91 | $9.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $30.20 Median $33.11 Typical High $35.48 | Facility | 54 · Surgery only | $30.20 | $33.11 | $35.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.03 Median $6.61 Typical High $7.08 | Facility | 55 · Aftercare only | $6.03 | $6.61 | $7.08 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.47 Typical High $4.68 | Facility | 56 · Pre-op care only | $4.07 | $4.47 | $4.68 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $28.18 Median $30.90 Typical High $33.11 | Facility | 78 · Unplanned return to OR | $28.18 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $21.38 Typical High $23.44 | Professional | 52 · Reduced service | $19.95 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.51 Typical High $9.33 | Professional | 53 · Discontinued | $7.94 | $8.51 | $9.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $32.36 Typical High $35.48 | Professional | 54 · Surgery only | $29.51 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.46 Typical High $7.08 | Professional | 55 · Aftercare only | $6.03 | $6.46 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.27 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.98 | $4.27 | $4.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $27.54 Median $30.20 Typical High $33.11 | Professional | 78 · Unplanned return to OR | $27.54 | $30.20 | $33.11 |
Where California sits
The same service costs 4.6 times more in Alaska than in New York. 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· 45th of 51
$48.98
AK $200NY $43.65
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.