How much rates vary
Facilitymedian $1,202 · 10th to 90th $316 to $6,761Professionalmedian $331 · 10th to 90th $240 to $977
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 $239.88 Median $316.23 Typical High $512.86 | Professional | None | $239.88 | $316.23 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $380.19 Typical High $380.19 | Professional | None | $128.82 | $380.19 | $380.19 |
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 $295.12 Median $295.12 Typical High $831.76 | Professional | None | $295.12 | $295.12 | $831.76 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,348.96 Typical High $6,309.57 | Facility | None | $100.00 | $1,348.96 | $6,309.57 |
Blue Shield Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $467.74 | Professional | None | $218.78 | $346.74 | $467.74 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $575.44 | Professional | None | $281.84 | $416.87 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $478.63 Typical High $954.99 | Facility | None | $61.66 | $478.63 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $562.34 | Professional | None | $257.04 | $354.81 | $562.34 |
Contra Costa Health Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $562.34 | Professional | None | $269.15 | $338.84 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $446.68 Typical High $831.76 | Professional | None | $263.03 | $446.68 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,467.37 | Professional | None | $2,691.53 | $2,691.53 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $524.81 | Professional | None | $316.23 | $316.23 | $524.81 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $478.63 Typical High $933.25 | Facility | None | $66.07 | $478.63 | $933.25 |
Providence Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $537.03 | Professional | None | $257.04 | $331.13 | $537.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,202.26 | Professional | None | $851.14 | $851.14 | $1,202.26 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,230.27 Typical High $4,677.35 | Facility | None | $398.11 | $1,230.27 | $4,677.35 |
United Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $630.96 | Professional | None | $208.93 | $309.03 | $630.96 |
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 $117.49 Median $128.82 Typical High $177.83 | Facility | 52 · Reduced service | $117.49 | $128.82 | $177.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $47.86 Median $51.29 Typical High $70.79 | Facility | 53 · Discontinued | $47.86 | $51.29 | $70.79 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $35.48 Median $38.90 Typical High $52.48 | Facility | 55 · Aftercare only | $35.48 | $38.90 | $52.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.70 Typical High $35.48 | Facility | 56 · Pre-op care only | $23.99 | $25.70 | $35.48 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $181.97 Typical High $245.47 | Facility | 78 · Unplanned return to OR | $165.96 | $181.97 | $245.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $138.04 Typical High $177.83 | Professional | 52 · Reduced service | $112.20 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $56.23 Typical High $70.79 | Professional | 53 · Discontinued | $44.67 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $208.93 Typical High $263.03 | Professional | 54 · Surgery only | $165.96 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $41.69 Typical High $52.48 | Professional | 55 · Aftercare only | $33.11 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $27.54 Typical High $35.48 | Professional | 56 · Pre-op care only | $22.39 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $194.98 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $154.88 | $194.98 | $245.47 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $48.98 Typical High $70.79 | Professional | 80 · Assistant surgeon | $39.81 | $48.98 | $70.79 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $43.65 Typical High $61.66 | Professional | AS · PA/NP assist | $34.67 | $43.65 | $61.66 |
Where California sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 39th of 51
$339
AK $1,072TX $240
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.