How much rates vary
Facilitymedian $2,570 · 10th to 90th $661 to $8,913Professionalmedian $468 · 10th to 90th $355 to $1,950
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 $389.05 Median $426.58 Typical High $575.44 | Professional | None | $389.05 | $426.58 | $575.44 |
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 $380.19 Median $467.74 Typical High $1,122.02 | Professional | None | $380.19 | $467.74 | $1,122.02 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,905.46 Typical High $6,760.83 | Facility | None | $100.00 | $1,905.46 | $6,760.83 |
Blue Shield Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $616.60 | Professional | None | $302.00 | $436.52 | $616.60 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $676.08 | Professional | None | $302.00 | $457.09 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,187.76 Typical High $4,466.84 | Facility | None | $575.44 | $2,187.76 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $794.33 | Professional | None | $398.11 | $501.19 | $794.33 |
Contra Costa Health Setting Professional Modifier None Typical Low $186.21 Median $446.68 Typical High $660.69 | Professional | None | $186.21 | $446.68 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $1,096.48 | Professional | None | $354.81 | $537.03 | $1,096.48 |
Lucent Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $4,168.69 | Professional | None | $3,388.44 | $3,388.44 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $645.65 | Professional | None | $389.05 | $389.05 | $645.65 |
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 $501.19 Median $2,089.30 Typical High $4,897.79 | Facility | None | $501.19 | $2,089.30 | $4,897.79 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $741.31 | Professional | None | $398.11 | $478.63 | $741.31 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,288.25 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,090.30 | $10,964.78 |
United Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $851.14 | Professional | None | $309.03 | $436.52 | $851.14 |
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 $194.98 Median $208.93 Typical High $269.15 | Facility | 52 · Reduced service | $194.98 | $208.93 | $269.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $77.62 Median $85.11 Typical High $107.15 | Facility | 53 · Discontinued | $77.62 | $85.11 | $107.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $288.40 Median $316.23 Typical High $407.38 | Facility | 54 · Surgery only | $288.40 | $316.23 | $407.38 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $57.54 Median $63.10 Typical High $81.28 | Facility | 55 · Aftercare only | $57.54 | $63.10 | $81.28 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $38.90 Median $42.66 Typical High $53.70 | Facility | 56 · Pre-op care only | $38.90 | $42.66 | $53.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $295.12 Typical High $380.19 | Facility | 78 · Unplanned return to OR | $269.15 | $295.12 | $380.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $213.80 Typical High $251.19 | Professional | 52 · Reduced service | $181.97 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $85.11 Typical High $102.33 | Professional | 53 · Discontinued | $72.44 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $323.59 Typical High $380.19 | Professional | 54 · Surgery only | $269.15 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $64.57 Typical High $75.86 | Professional | 55 · Aftercare only | $54.95 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $42.66 Typical High $50.12 | Professional | 56 · Pre-op care only | $36.31 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $302.00 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $251.19 | $302.00 | $354.81 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 51 · Multiple procedures | $251.19 | $251.19 | $251.19 |
Where California sits
The same service costs 6.0 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· 35th of 51
$490
AK $1,778TX $295
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.