How much rates vary
Facilitymedian $759 · 10th to 90th $102 to $6,310Professionalmedian $115 · 10th to 90th $83 to $380
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 $83.18 Median $91.20 Typical High $114.82 | Professional | None | $83.18 | $91.20 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $2,137.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $218.78 | Professional | None | $95.50 | $128.82 | $218.78 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $426.58 Typical High $1,659.59 | Facility | None | $97.72 | $426.58 | $1,659.59 |
Blue Shield Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $165.96 | Professional | None | $77.62 | $112.20 | $165.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $181.97 | Professional | None | $91.20 | $144.54 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $131.83 Typical High $275.42 | Facility | None | $53.70 | $131.83 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $181.97 | Professional | None | $85.11 | $109.65 | $181.97 |
Contra Costa Health Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $177.83 | Professional | None | $100.00 | $117.49 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $269.15 | Professional | None | $87.10 | $141.25 | $269.15 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,479.11 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $173.78 | Professional | None | $104.71 | $104.71 | $173.78 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $134.90 Typical High $323.59 | Facility | None | $58.88 | $134.90 | $323.59 |
Providence Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $181.97 | Professional | None | $85.11 | $107.15 | $181.97 |
Sutter Health Plus Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $380.19 | Professional | None | $288.40 | $288.40 | $380.19 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $194.98 | Professional | None | $69.18 | $104.71 | $194.98 |
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 $57.54 | Facility | 52 · Reduced service | $41.69 | $44.67 | $57.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.60 Median $18.20 Typical High $22.91 | Facility | 53 · Discontinued | $16.60 | $18.20 | $22.91 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $63.10 Median $67.61 Typical High $85.11 | Facility | 54 · Surgery only | $63.10 | $67.61 | $85.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.59 Median $13.49 Typical High $16.98 | Facility | 55 · Aftercare only | $12.59 | $13.49 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.12 Typical High $11.48 | Facility | 56 · Pre-op care only | $8.32 | $9.12 | $11.48 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $63.10 Typical High $79.43 | Facility | 78 · Unplanned return to OR | $58.88 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $45.71 Typical High $57.54 | Professional | 52 · Reduced service | $38.90 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $18.20 Typical High $22.91 | Professional | 53 · Discontinued | $15.85 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $69.18 Typical High $85.11 | Professional | 54 · Surgery only | $58.88 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.80 Typical High $16.98 | Professional | 55 · Aftercare only | $11.75 | $13.80 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.12 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.94 | $9.12 | $11.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $64.57 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $54.95 | $64.57 | $79.43 |
Where California sits
The same service costs 4.0 times more in Alaska than in Florida. 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
$117
AK $363FL $91.20
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.