How much rates vary
Facilitymedian $3,236 · 10th to 90th $912 to $10,965Professionalmedian $724 · 10th to 90th $575 to $2,884
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 $1,949.84 Median $7,413.10 Typical High $18,197.01 | Facility | None | $1,949.84 | $7,413.10 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,230.27 | Professional | None | $575.44 | $691.83 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,606.93 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $2,630.27 | Professional | None | $676.08 | $758.58 | $2,630.27 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,398.83 Typical High $9,332.54 | Facility | None | $100.00 | $2,398.83 | $9,332.54 |
Blue Shield Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $1,584.89 | Professional | None | $446.68 | $630.96 | $1,584.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $316.23 Median $537.03 Typical High $794.33 | Professional | None | $316.23 | $537.03 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,511.89 Typical High $5,370.32 | Facility | None | $758.58 | $2,511.89 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $1,819.70 | Professional | None | $645.65 | $741.31 | $1,819.70 |
Contra Costa Health Setting Professional Modifier None Typical Low $251.19 Median $724.44 Typical High $870.96 | Professional | None | $251.19 | $724.44 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,905.46 | Professional | None | $630.96 | $794.33 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Professional | None | $6,309.57 | $6,309.57 | $6,309.57 |
Molina Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $2,511.89 Typical High $6,456.54 | Facility | None | $758.58 | $2,511.89 | $6,456.54 |
Providence Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,819.70 | Professional | None | $630.96 | $724.44 | $1,819.70 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,365.16 | $14,454.40 |
United Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $2,089.30 | Professional | None | $537.03 | $724.44 | $2,089.30 |
8 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 Professional Modifier 52 · Reduced service Typical Low $288.40 Median $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $288.40 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $125.89 Typical High $131.83 | Professional | 53 · Discontinued | $114.82 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $467.74 Typical High $501.19 | Professional | 54 · Surgery only | $426.58 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $93.33 Typical High $100.00 | Professional | 55 · Aftercare only | $87.10 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $61.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $57.54 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $436.52 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $398.11 | $436.52 | $467.74 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | 50 · Both sides | $2,041.74 | $2,041.74 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,047.13 Typical High $2,398.83 | Professional | 50 · Both sides | $831.76 | $1,047.13 | $2,398.83 |
Where California sits
The same service costs 3.9 times more in Connecticut than in Montana. 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.
Physician feeFacility fee
CT $8,362MT $2,119
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.