How much rates vary
Facilitymedian $1,349 · 10th to 90th $263 to $6,607Professionalmedian $214 · 10th to 90th $148 to $1,000
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 $144.54 Median $169.82 Typical High $245.47 | Professional | None | $144.54 | $169.82 | $245.47 |
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 $147.91 Median $194.98 Typical High $489.78 | Professional | None | $147.91 | $194.98 | $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 $117.49 Median $173.78 Typical High $288.40 | Professional | None | $117.49 | $173.78 | $288.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $380.19 | Professional | None | $162.18 | $208.93 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $363.08 Typical High $1,412.54 | Facility | None | $245.47 | $363.08 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $407.38 | Professional | None | $158.49 | $234.42 | $407.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $371.54 | Professional | None | $123.03 | $194.98 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $537.03 | Professional | None | $154.88 | $288.40 | $537.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,862.09 | $1,862.09 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $363.08 | Professional | None | $218.78 | $218.78 | $363.08 |
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 $223.87 Median $380.19 Typical High $3,311.31 | Facility | None | $223.87 | $380.19 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $363.08 | Professional | None | $158.49 | $234.42 | $363.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $870.96 | Professional | None | $537.03 | $537.03 | $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 $131.83 Median $218.78 Typical High $436.52 | Professional | None | $131.83 | $218.78 | $436.52 |
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 $77.62 Median $85.11 Typical High $134.90 | Facility | 52 · Reduced service | $77.62 | $85.11 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $31.62 Median $33.88 Typical High $54.95 | Facility | 53 · Discontinued | $31.62 | $33.88 | $54.95 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $128.82 Typical High $204.17 | Facility | 54 · Surgery only | $117.49 | $128.82 | $204.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $25.70 Typical High $40.74 | Facility | 55 · Aftercare only | $23.44 | $25.70 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.98 Typical High $26.92 | Facility | 56 · Pre-op care only | $15.85 | $16.98 | $26.92 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $120.23 Typical High $190.55 | Facility | 78 · Unplanned return to OR | $109.65 | $120.23 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $107.15 Typical High $131.83 | Professional | 52 · Reduced service | $74.13 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $42.66 Typical High $52.48 | Professional | 53 · Discontinued | $29.51 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $158.49 Typical High $194.98 | Professional | 54 · Surgery only | $109.65 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $31.62 Typical High $38.90 | Professional | 55 · Aftercare only | $21.88 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $21.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $14.79 | $21.38 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $147.91 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $102.33 | $147.91 | $181.97 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $245.47 Median $323.59 Typical High $457.09 | Professional | 50 · Both sides | $245.47 | $323.59 | $457.09 |
Where California sits
The same service costs 3.7 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· 40th of 51
$224
AK $692UT $186
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.