How much rates vary
Facilitymedian $1,660 · 10th to 90th $427 to $6,607Professionalmedian $240 · 10th to 90th $182 to $1,096
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 $194.98 Median $208.93 Typical High $229.09 | Professional | None | $194.98 | $208.93 | $229.09 |
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 $199.53 Median $251.19 Typical High $630.96 | Professional | None | $199.53 | $251.19 | $630.96 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,479.11 Typical High $5,248.07 | Facility | None | $100.00 | $1,479.11 | $5,248.07 |
Blue Shield Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $302.00 | Professional | None | $151.36 | $218.78 | $302.00 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $380.19 | Professional | None | $234.42 | $346.74 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,348.96 Typical High $2,187.76 | Facility | None | $426.58 | $1,348.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $380.19 | Professional | None | $194.98 | $239.88 | $380.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $177.83 Median $338.84 Typical High $407.38 | Professional | None | $177.83 | $338.84 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $660.69 | Professional | None | $263.03 | $331.13 | $660.69 |
Lucent Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,344.23 | Professional | None | $1,819.70 | $1,819.70 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $354.81 | Professional | None | $213.80 | $213.80 | $354.81 |
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 $1,288.25 Typical High $2,884.03 | Facility | None | $316.23 | $1,288.25 | $2,884.03 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $371.54 | Professional | None | $194.98 | $239.88 | $371.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
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 $177.83 Median $218.78 Typical High $407.38 | Professional | None | $177.83 | $218.78 | $407.38 |
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 $95.50 Median $104.71 Typical High $114.82 | Facility | 52 · Reduced service | $95.50 | $104.71 | $114.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.90 Median $41.69 Typical High $45.71 | Facility | 53 · Discontinued | $38.90 | $41.69 | $45.71 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $144.54 Median $158.49 Typical High $173.78 | Facility | 54 · Surgery only | $144.54 | $158.49 | $173.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $31.62 Typical High $34.67 | Facility | 55 · Aftercare only | $28.84 | $31.62 | $34.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.50 Median $20.89 Typical High $22.91 | Facility | 56 · Pre-op care only | $19.50 | $20.89 | $22.91 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $147.91 Typical High $162.18 | Facility | 78 · Unplanned return to OR | $134.90 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $104.71 Typical High $114.82 | Professional | 52 · Reduced service | $95.50 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $41.69 Typical High $45.71 | Professional | 53 · Discontinued | $38.90 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $158.49 Typical High $173.78 | Professional | 54 · Surgery only | $144.54 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $31.62 Typical High $34.67 | Professional | 55 · Aftercare only | $28.84 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $20.89 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.50 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $147.91 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $134.90 | $147.91 | $162.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $354.81 Typical High $645.65 | Professional | 50 · Both sides | $275.42 | $354.81 | $645.65 |
Where California sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 42nd of 51
$245
AK $1,023UT $191
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.