How much rates vary
Facilitymedian $3,548 · 10th to 90th $589 to $8,913Professionalmedian $537 · 10th to 90th $309 to $3,090
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 $660.69 Median $5,888.44 Typical High $15,848.93 | Facility | None | $660.69 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $660.69 | Professional | None | $331.13 | $501.19 | $660.69 |
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 $316.23 Median $389.05 Typical High $1,202.26 | Professional | None | $316.23 | $389.05 | $1,202.26 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,754.23 Typical High $7,244.36 | Facility | None | $100.00 | $2,754.23 | $7,244.36 |
Blue Shield Setting Professional Modifier None Typical Low $218.78 Median $446.68 Typical High $831.76 | Professional | None | $218.78 | $446.68 | $831.76 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $1,174.90 | Professional | None | $501.19 | $691.83 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $4,168.69 Typical High $7,413.10 | Facility | None | $575.44 | $4,168.69 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $588.84 Typical High $1,096.48 | Professional | None | $309.03 | $588.84 | $1,096.48 |
Contra Costa Health Setting Professional Modifier None Typical Low $331.13 Median $676.08 Typical High $1,148.15 | Professional | None | $331.13 | $676.08 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $851.14 Typical High $1,698.24 | Professional | None | $489.78 | $851.14 | $1,698.24 |
Lucent Health Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $6,606.93 | Professional | None | $5,754.40 | $5,754.40 | $6,606.93 |
Molina Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,000.00 | Professional | None | $602.56 | $602.56 | $1,000.00 |
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 $524.81 Median $3,715.35 Typical High $7,079.46 | Facility | None | $524.81 | $3,715.35 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $309.03 Median $588.84 Typical High $1,023.29 | Professional | None | $309.03 | $588.84 | $1,023.29 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,412.54 | $1,412.54 | $2,398.83 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,456.54 | Facility | None | $616.60 | $1,621.81 | $6,456.54 |
United Setting Professional Modifier None Typical Low $316.23 Median $562.34 Typical High $1,288.25 | Professional | None | $316.23 | $562.34 | $1,288.25 |
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 $165.96 Median $186.21 Typical High $331.13 | Facility | 52 · Reduced service | $165.96 | $186.21 | $331.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $66.07 Median $74.13 Typical High $131.83 | Facility | 53 · Discontinued | $66.07 | $74.13 | $131.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $251.19 Median $275.42 Typical High $489.78 | Facility | 54 · Surgery only | $251.19 | $275.42 | $489.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $50.12 Median $56.23 Typical High $100.00 | Facility | 55 · Aftercare only | $50.12 | $56.23 | $100.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $66.07 | Facility | 56 · Pre-op care only | $33.11 | $37.15 | $66.07 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $257.04 Typical High $457.09 | Facility | 78 · Unplanned return to OR | $234.42 | $257.04 | $457.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $251.19 Typical High $331.13 | Professional | 52 · Reduced service | $151.36 | $251.19 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $100.00 Typical High $131.83 | Professional | 53 · Discontinued | $61.66 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $371.54 Typical High $489.78 | Professional | 54 · Surgery only | $229.09 | $371.54 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $74.13 Typical High $100.00 | Professional | 55 · Aftercare only | $45.71 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $50.12 Typical High $66.07 | Professional | 56 · Pre-op care only | $30.20 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $346.74 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $213.80 | $346.74 | $457.09 |
Where California sits
The same service costs 5.9 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· 41st of 51
$575
AK $2,138KY $363
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.