How much rates vary
Facilitymedian $1,514 · 10th to 90th $427 to $6,607Professionalmedian $224 · 10th to 90th $141 to $724
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 $354.81 Median $5,128.61 Typical High $15,135.61 | Facility | None | $354.81 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $309.03 | Professional | None | $147.91 | $229.09 | $309.03 |
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 $138.04 Median $181.97 Typical High $489.78 | Professional | None | $138.04 | $181.97 | $489.78 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,348.96 Typical High $4,786.30 | Facility | None | $100.00 | $1,348.96 | $4,786.30 |
Blue Shield Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $309.03 | Professional | None | $114.82 | $181.97 | $309.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $398.11 | Professional | None | $123.03 | $190.55 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,148.15 Typical High $2,344.23 | Facility | None | $426.58 | $1,148.15 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $407.38 | Professional | None | $151.36 | $245.47 | $407.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $74.13 Median $186.21 Typical High $389.05 | Professional | None | $74.13 | $186.21 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $288.40 Typical High $549.54 | Professional | None | $147.91 | $288.40 | $549.54 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,905.46 | $1,905.46 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $371.54 | Professional | None | $223.87 | $223.87 | $371.54 |
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 $316.23 Median $1,122.02 Typical High $3,311.31 | Facility | None | $316.23 | $1,122.02 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $371.54 | Professional | None | $151.36 | $245.47 | $371.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $870.96 | Professional | None | $512.86 | $512.86 | $870.96 |
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 $125.89 Median $223.87 Typical High $457.09 | Professional | None | $125.89 | $223.87 | $457.09 |
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 $74.13 Median $79.43 Typical High $138.04 | Facility | 52 · Reduced service | $74.13 | $79.43 | $138.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $29.51 Median $32.36 Typical High $54.95 | Facility | 53 · Discontinued | $29.51 | $32.36 | $54.95 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $112.20 Median $120.23 Typical High $208.93 | Facility | 54 · Surgery only | $112.20 | $120.23 | $208.93 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.39 Median $23.99 Typical High $41.69 | Facility | 55 · Aftercare only | $22.39 | $23.99 | $41.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.22 Typical High $27.54 | Facility | 56 · Pre-op care only | $14.79 | $16.22 | $27.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $112.20 Typical High $194.98 | Facility | 78 · Unplanned return to OR | $104.71 | $112.20 | $194.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $109.65 Typical High $134.90 | Professional | 52 · Reduced service | $69.18 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $43.65 Typical High $53.70 | Professional | 53 · Discontinued | $27.54 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $162.18 Typical High $199.53 | Professional | 54 · Surgery only | $104.71 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $32.36 Typical High $39.81 | Professional | 55 · Aftercare only | $20.89 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $21.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $13.80 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $151.36 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $97.72 | $151.36 | $186.21 |
Where California sits
The same service costs 4.5 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
$234
AK $759KY $170
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.