How much rates vary
Facilitymedian $2,138 · 10th to 90th $631 to $8,128Professionalmedian $646 · 10th to 90th $457 to $3,020
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 $741.31 Median $5,888.44 Typical High $15,848.93 | Facility | None | $741.31 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $741.31 | Professional | None | $512.86 | $616.60 | $741.31 |
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 $537.03 Median $660.69 Typical High $1,621.81 | Professional | None | $537.03 | $660.69 | $1,621.81 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,691.53 Typical High $6,760.83 | Facility | None | $100.00 | $2,691.53 | $6,760.83 |
Blue Shield Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $724.44 | Professional | None | $354.81 | $524.81 | $724.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $346.74 Median $812.83 Typical High $1,071.52 | Professional | None | $346.74 | $812.83 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,071.52 Typical High $1,862.09 | Facility | None | $575.44 | $1,071.52 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $1,122.02 | Professional | None | $524.81 | $724.44 | $1,122.02 |
Contra Costa Health Setting Professional Modifier None Typical Low $269.15 Median $794.33 Typical High $1,047.13 | Professional | None | $269.15 | $794.33 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,698.24 | Professional | None | $602.56 | $812.83 | $1,698.24 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,165.95 | Professional | None | $5,128.61 | $5,128.61 | $6,165.95 |
Molina Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $977.24 | Professional | None | $588.84 | $588.84 | $977.24 |
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 $575.44 Median $1,096.48 Typical High $3,311.31 | Facility | None | $575.44 | $1,096.48 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,096.48 | Professional | None | $524.81 | $676.08 | $1,096.48 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,905.46 | $1,905.46 | $2,290.87 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $1,230.27 | Professional | None | $457.09 | $602.56 | $1,230.27 |
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 $275.42 Median $309.03 Typical High $371.54 | Facility | 52 · Reduced service | $275.42 | $309.03 | $371.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $112.20 Median $123.03 Typical High $147.91 | Facility | 53 · Discontinued | $112.20 | $123.03 | $147.91 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $416.87 Median $467.74 Typical High $549.54 | Facility | 54 · Surgery only | $416.87 | $467.74 | $549.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $83.18 Median $93.33 Typical High $112.20 | Facility | 55 · Aftercare only | $83.18 | $93.33 | $112.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $56.23 Median $61.66 Typical High $74.13 | Facility | 56 · Pre-op care only | $56.23 | $61.66 | $74.13 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $436.52 Typical High $512.86 | Facility | 78 · Unplanned return to OR | $389.05 | $436.52 | $512.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $302.00 Typical High $371.54 | Professional | 52 · Reduced service | $257.04 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $120.23 Typical High $147.91 | Professional | 53 · Discontinued | $102.33 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $457.09 Typical High $549.54 | Professional | 54 · Surgery only | $389.05 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $91.20 Typical High $112.20 | Professional | 55 · Aftercare only | $77.62 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $60.26 Typical High $74.13 | Professional | 56 · Pre-op care only | $51.29 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $426.58 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $363.08 | $426.58 | $512.86 |
Where California sits
The same service costs 5.6 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
$661
AK $2,399TX $427
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.