How much rates vary
Facilitymedian $589 · 10th to 90th $257 to $5,370Professionalmedian $195 · 10th to 90th $132 to $479
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 $239.88 Median $5,754.40 Typical High $15,848.93 | Facility | None | $239.88 | $5,754.40 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $363.08 | Professional | None | $131.83 | $186.21 | $363.08 |
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 $162.18 Median $218.78 Typical High $371.54 | Professional | None | $162.18 | $218.78 | $371.54 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,513.56 Typical High $4,897.79 | Facility | None | $100.00 | $1,513.56 | $4,897.79 |
Blue Shield Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $263.03 | Professional | None | $112.20 | $162.18 | $263.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $331.13 | Professional | None | $141.25 | $190.55 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $331.13 Typical High $1,047.13 | Facility | None | $213.80 | $331.13 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $331.13 | Professional | None | $144.54 | $199.53 | $331.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $323.59 | Professional | None | $112.20 | $190.55 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $257.04 Typical High $478.63 | Professional | None | $147.91 | $257.04 | $478.63 |
Lucent Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,698.24 | $1,698.24 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $309.03 | Professional | None | $181.97 | $181.97 | $309.03 |
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 $194.98 Median $338.84 Typical High $2,570.40 | Facility | None | $194.98 | $338.84 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $309.03 | Professional | None | $138.04 | $194.98 | $309.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $691.83 | Professional | None | $478.63 | $478.63 | $691.83 |
United Setting Facility Modifier None Typical Low $549.54 Median $588.84 Typical High $2,290.87 | Facility | None | $549.54 | $588.84 | $2,290.87 |
United Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $363.08 | Professional | None | $117.49 | $177.83 | $363.08 |
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 $72.44 Typical High $102.33 | Facility | 52 · Reduced service | $66.07 | $72.44 | $102.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.92 Median $28.84 Typical High $40.74 | Facility | 53 · Discontinued | $26.92 | $28.84 | $40.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $100.00 Median $107.15 Typical High $151.36 | Facility | 54 · Surgery only | $100.00 | $107.15 | $151.36 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.95 Median $21.38 Typical High $30.20 | Facility | 55 · Aftercare only | $19.95 | $21.38 | $30.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.45 Typical High $20.42 | Facility | 56 · Pre-op care only | $13.18 | $14.45 | $20.42 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $100.00 Typical High $141.25 | Facility | 78 · Unplanned return to OR | $93.33 | $100.00 | $141.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $81.28 Typical High $102.33 | Professional | 52 · Reduced service | $63.10 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $32.36 Typical High $40.74 | Professional | 53 · Discontinued | $25.12 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $120.23 Typical High $151.36 | Professional | 54 · Surgery only | $93.33 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $23.99 Typical High $30.20 | Professional | 55 · Aftercare only | $18.62 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.22 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.59 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $112.20 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $87.10 | $112.20 | $141.25 |
Where California sits
The same service costs 3.5 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· 41st of 51
$204
AK $603FL $174
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.