How much rates vary
Facilitymedian $3,981 · 10th to 90th $708 to $9,772Professionalmedian $562 · 10th to 90th $427 to $1,072
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 $645.65 Median $5,888.44 Typical High $15,848.93 | Facility | None | $645.65 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $870.96 | Professional | None | $467.74 | $575.44 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $6,606.93 Typical High $13,489.63 | Facility | None | $2,951.21 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $1,318.26 | Professional | None | $436.52 | $562.34 | $1,318.26 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,818.38 Typical High $7,244.36 | Facility | None | $100.00 | $2,818.38 | $7,244.36 |
Blue Shield Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $741.31 | Professional | None | $363.08 | $537.03 | $741.31 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $812.83 | Professional | None | $457.09 | $562.34 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $4,466.84 Typical High $7,413.10 | Facility | None | $575.44 | $4,466.84 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $891.25 | Professional | None | $478.63 | $602.56 | $891.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $870.96 | Professional | None | $501.19 | $724.44 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $1,380.38 | Professional | None | $436.52 | $645.65 | $1,380.38 |
Lucent Health Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
Molina Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $758.58 | Professional | None | $446.68 | $446.68 | $758.58 |
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 $537.03 Median $3,715.35 Typical High $7,079.46 | Facility | None | $537.03 | $3,715.35 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $870.96 | Professional | None | $478.63 | $575.44 | $870.96 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,513.56 | $1,513.56 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $11,220.18 | Facility | None | $1,258.93 | $3,090.30 | $11,220.18 |
United Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $954.99 | Professional | None | $363.08 | $512.86 | $954.99 |
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 $234.42 Median $257.04 Typical High $323.59 | Facility | 52 · Reduced service | $234.42 | $257.04 | $323.59 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $93.33 Median $102.33 Typical High $128.82 | Facility | 53 · Discontinued | $93.33 | $102.33 | $128.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $478.63 | Facility | 54 · Surgery only | $346.74 | $380.19 | $478.63 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $70.79 Median $75.86 Typical High $95.50 | Facility | 55 · Aftercare only | $70.79 | $75.86 | $95.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $46.77 Median $51.29 Typical High $64.57 | Facility | 56 · Pre-op care only | $46.77 | $51.29 | $64.57 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $446.68 | Facility | 78 · Unplanned return to OR | $323.59 | $354.81 | $446.68 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $257.04 Typical High $295.12 | Professional | 52 · Reduced service | $218.78 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $102.33 Typical High $120.23 | Professional | 53 · Discontinued | $87.10 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $380.19 Typical High $446.68 | Professional | 54 · Surgery only | $323.59 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $75.86 Typical High $89.13 | Professional | 55 · Aftercare only | $66.07 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $51.29 Typical High $60.26 | Professional | 56 · Pre-op care only | $43.65 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $354.81 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $302.00 | $354.81 | $416.87 |
Where California sits
The same service costs 5.5 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· 34th of 51
$575
AK $2,089TX $380
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.