How much rates vary
Facilitymedian $447 · 10th to 90th $126 to $5,623Professionalmedian $302 · 10th to 90th $229 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 $245.47 Median $275.42 Typical High $501.19 | Professional | None | $245.47 | $275.42 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $281.84 Median $302.00 Typical High $758.58 | Professional | None | $281.84 | $302.00 | $758.58 |
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 $181.97 Median $269.15 Typical High $398.11 | Professional | None | $181.97 | $269.15 | $398.11 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $213.80 Median $398.11 Typical High $489.78 | Professional | None | $213.80 | $398.11 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $218.78 Typical High $457.09 | Facility | None | $53.70 | $218.78 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $309.03 Typical High $489.78 | Professional | None | $251.19 | $309.03 | $489.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $162.18 Median $398.11 Typical High $478.63 | Professional | None | $162.18 | $398.11 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $851.14 | Professional | None | $309.03 | $398.11 | $851.14 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,019.95 | Professional | None | $2,290.87 | $2,290.87 | $3,019.95 |
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 $61.66 Median $251.19 Typical High $562.34 | Facility | None | $61.66 | $251.19 | $562.34 |
Providence Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $478.63 | Professional | None | $251.19 | $302.00 | $478.63 |
Sutter Health Plus Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,000.00 | Professional | None | $933.25 | $933.25 | $1,000.00 |
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 $218.78 Median $275.42 Typical High $524.81 | Professional | None | $218.78 | $275.42 | $524.81 |
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 $123.03 Median $138.04 Typical High $151.36 | Facility | 52 · Reduced service | $123.03 | $138.04 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $48.98 Median $54.95 Typical High $61.66 | Facility | 53 · Discontinued | $48.98 | $54.95 | $61.66 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $181.97 Median $204.17 Typical High $229.09 | Facility | 54 · Surgery only | $181.97 | $204.17 | $229.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $36.31 Median $40.74 Typical High $45.71 | Facility | 55 · Aftercare only | $36.31 | $40.74 | $45.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $24.55 Median $27.54 Typical High $30.20 | Facility | 56 · Pre-op care only | $24.55 | $27.54 | $30.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $190.55 Typical High $213.80 | Facility | 78 · Unplanned return to OR | $169.82 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $138.04 Typical High $151.36 | Professional | 52 · Reduced service | $117.49 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $54.95 Typical High $61.66 | Professional | 53 · Discontinued | $46.77 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $204.17 Typical High $229.09 | Professional | 54 · Surgery only | $177.83 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $40.74 Typical High $45.71 | Professional | 55 · Aftercare only | $35.48 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $27.54 Typical High $30.20 | Professional | 56 · Pre-op care only | $23.44 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $190.55 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $165.96 | $190.55 | $213.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $467.74 Typical High $758.58 | Professional | 50 · Both sides | $380.19 | $467.74 | $758.58 |
Where California sits
The same service costs 5.8 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· 37th of 51
$302
AK $1,202TX $209
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.