How much rates vary
Facilitymedian $631 · 10th to 90th $331 to $5,129Professionalmedian $302 · 10th to 90th $138 to $912
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 $436.52 Median $5,128.61 Typical High $15,135.61 | Facility | None | $436.52 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $331.13 Typical High $562.34 | Professional | None | $138.04 | $331.13 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $933.25 | Professional | None | $128.82 | $169.82 | $933.25 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,096.48 Typical High $4,786.30 | Facility | None | $100.00 | $1,096.48 | $4,786.30 |
Blue Shield Setting Professional Modifier None Typical Low $120.23 Median $309.03 Typical High $537.03 | Professional | None | $120.23 | $309.03 | $537.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $549.54 | Professional | None | $138.04 | $190.55 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,148.15 Typical High $2,344.23 | Facility | None | $426.58 | $1,148.15 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $363.08 Typical High $602.56 | Professional | None | $147.91 | $363.08 | $602.56 |
Contra Costa Health Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $549.54 | Professional | None | $114.82 | $186.21 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $398.11 Typical High $758.58 | Professional | None | $147.91 | $398.11 | $758.58 |
Lucent Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,235.94 | Professional | None | $2,884.03 | $2,884.03 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $489.78 | Professional | None | $295.12 | $295.12 | $489.78 |
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 $331.13 Median $1,122.02 Typical High $3,235.94 | Facility | None | $331.13 | $1,122.02 | $3,235.94 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $363.08 Typical High $588.84 | Professional | None | $147.91 | $363.08 | $588.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $1,230.27 | Professional | None | $478.63 | $478.63 | $1,230.27 |
United Setting Facility Modifier None Typical Low $331.13 Median $575.44 Typical High $1,621.81 | Facility | None | $331.13 | $575.44 | $1,621.81 |
United Setting Professional Modifier None Typical Low $117.49 Median $295.12 Typical High $645.65 | Professional | None | $117.49 | $295.12 | $645.65 |
13 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 $69.18 Median $75.86 Typical High $218.78 | Facility | 52 · Reduced service | $69.18 | $75.86 | $218.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $27.54 Median $30.20 Typical High $87.10 | Facility | 53 · Discontinued | $27.54 | $30.20 | $87.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $104.71 Median $112.20 Typical High $323.59 | Facility | 54 · Surgery only | $104.71 | $112.20 | $323.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.89 Median $22.39 Typical High $64.57 | Facility | 55 · Aftercare only | $20.89 | $22.39 | $64.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.14 Typical High $43.65 | Facility | 56 · Pre-op care only | $13.80 | $15.14 | $43.65 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $104.71 Typical High $302.00 | Facility | 78 · Unplanned return to OR | $97.72 | $104.71 | $302.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $144.54 Typical High $190.55 | Professional | 52 · Reduced service | $64.57 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $57.54 Typical High $75.86 | Professional | 53 · Discontinued | $25.70 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $218.78 Typical High $288.40 | Professional | 54 · Surgery only | $97.72 | $218.78 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $43.65 Typical High $57.54 | Professional | 55 · Aftercare only | $19.50 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $28.84 Typical High $38.02 | Professional | 56 · Pre-op care only | $12.88 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $204.17 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $91.20 | $204.17 | $269.15 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 58 · Staged procedure | $173.78 | $173.78 | $173.78 |
Where California sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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· 25th of 51
$347
AK $759KY $191
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.