How much rates vary
Facilitymedian $457 · 10th to 90th $93 to $5,370Professionalmedian $110 · 10th to 90th $78 to $263
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 $93.33 Median $6,606.93 Typical High $18,197.01 | Facility | None | $93.33 | $6,606.93 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $173.78 | Professional | None | $77.62 | $117.49 | $173.78 |
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 $95.50 Median $100.00 Typical High $263.03 | Professional | None | $95.50 | $100.00 | $263.03 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $426.58 Typical High $1,445.44 | Facility | None | $100.00 | $426.58 | $1,445.44 |
Blue Shield Setting Professional Modifier None Typical Low $61.66 Median $97.72 Typical High $165.96 | Professional | None | $61.66 | $97.72 | $165.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $194.98 | Professional | None | $91.20 | $134.90 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $131.83 Typical High $758.58 | Facility | None | $83.18 | $131.83 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $173.78 | Professional | None | $83.18 | $123.03 | $173.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $144.54 | Professional | None | $85.11 | $114.82 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $117.49 Typical High $245.47 | Professional | None | $74.13 | $117.49 | $245.47 |
Lucent Health Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,047.13 | Professional | None | $891.25 | $1,047.13 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $147.91 | Professional | None | $89.13 | $89.13 | $147.91 |
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 $85.11 Median $169.82 Typical High $2,570.40 | Facility | None | $85.11 | $169.82 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $165.96 | Professional | None | $83.18 | $120.23 | $165.96 |
Sutter Health Plus Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | None | $263.03 | $263.03 | $338.84 |
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 $66.07 Median $97.72 Typical High $169.82 | Professional | None | $66.07 | $97.72 | $169.82 |
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 $39.81 Median $42.66 Typical High $64.57 | Facility | 52 · Reduced service | $39.81 | $42.66 | $64.57 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.85 Median $16.98 Typical High $25.70 | Facility | 53 · Discontinued | $15.85 | $16.98 | $25.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $60.26 Median $64.57 Typical High $97.72 | Facility | 54 · Surgery only | $60.26 | $64.57 | $97.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $12.88 Typical High $19.50 | Facility | 55 · Aftercare only | $12.02 | $12.88 | $19.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.51 Typical High $12.88 | Facility | 56 · Pre-op care only | $7.94 | $8.51 | $12.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $60.26 Typical High $91.20 | Facility | 78 · Unplanned return to OR | $56.23 | $60.26 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $50.12 Typical High $58.88 | Professional | 52 · Reduced service | $38.02 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.95 Typical High $23.44 | Professional | 53 · Discontinued | $15.14 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $74.13 Typical High $87.10 | Professional | 54 · Surgery only | $56.23 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $14.79 Typical High $17.78 | Professional | 55 · Aftercare only | $11.22 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $10.00 Typical High $11.75 | Professional | 56 · Pre-op care only | $7.59 | $10.00 | $11.75 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $52.48 Median $69.18 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $52.48 | $69.18 | $81.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $144.54 Typical High $229.09 | Professional | 50 · Both sides | $114.82 | $144.54 | $229.09 |
Where California sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 36th of 51
$115
AK $324FL $83.18
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.