How much rates vary
Facilitymedian $1,096 · 10th to 90th $170 to $6,310Professionalmedian $295 · 10th to 90th $224 to $977
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 $478.63 Median $5,128.61 Typical High $15,135.61 | Facility | None | $478.63 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $398.11 | Professional | None | $239.88 | $275.42 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $776.25 | Professional | None | $275.42 | $316.23 | $776.25 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,412.54 Typical High $5,248.07 | Facility | None | $100.00 | $1,412.54 | $5,248.07 |
Blue Shield Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $323.59 | Professional | None | $165.96 | $234.42 | $323.59 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $223.87 Median $389.05 Typical High $467.74 | Professional | None | $223.87 | $389.05 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $295.12 Typical High $1,348.96 | Facility | None | $181.97 | $295.12 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $478.63 | Professional | None | $257.04 | $309.03 | $478.63 |
Contra Costa Health Setting Professional Modifier None Typical Low $138.04 Median $389.05 Typical High $457.09 | Professional | None | $138.04 | $389.05 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $831.76 | Professional | None | $302.00 | $389.05 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,951.21 | Professional | None | $2,290.87 | $2,290.87 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $446.68 | Professional | None | $269.15 | $269.15 | $446.68 |
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 $190.55 Median $371.54 Typical High $2,454.71 | Facility | None | $190.55 | $371.54 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $467.74 | Professional | None | $257.04 | $295.12 | $467.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $977.24 | Professional | None | $954.99 | $954.99 | $977.24 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $512.86 | Professional | None | $223.87 | $275.42 | $512.86 |
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 $120.23 Median $134.90 Typical High $147.91 | Facility | 52 · Reduced service | $120.23 | $134.90 | $147.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $48.98 Median $53.70 Typical High $58.88 | Facility | 53 · Discontinued | $48.98 | $53.70 | $58.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $181.97 Median $204.17 Typical High $218.78 | Facility | 54 · Surgery only | $181.97 | $204.17 | $218.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $36.31 Median $40.74 Typical High $44.67 | Facility | 55 · Aftercare only | $36.31 | $40.74 | $44.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $23.99 Median $26.92 Typical High $29.51 | Facility | 56 · Pre-op care only | $23.99 | $26.92 | $29.51 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $190.55 Typical High $204.17 | Facility | 78 · Unplanned return to OR | $169.82 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $134.90 Typical High $147.91 | Professional | 52 · Reduced service | $120.23 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $53.70 Typical High $58.88 | Professional | 53 · Discontinued | $47.86 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $204.17 Typical High $218.78 | Professional | 54 · Surgery only | $177.83 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $40.74 Typical High $44.67 | Professional | 55 · Aftercare only | $35.48 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $26.92 Typical High $29.51 | Professional | 56 · Pre-op care only | $23.99 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $190.55 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $165.96 | $190.55 | $204.17 |
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· 40th of 51
$302
AK $1,230TX $224
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.