How much rates vary
Facilitymedian $398 · 10th to 90th $117 to $5,495Professionalmedian $229 · 10th to 90th $123 to $708
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 $223.87 Median $6,760.83 Typical High $18,197.01 | Facility | None | $223.87 | $6,760.83 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $245.47 Typical High $478.63 | Professional | None | $125.89 | $245.47 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
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 $120.23 Median $151.36 Typical High $537.03 | Professional | None | $120.23 | $151.36 | $537.03 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $1,479.11 | Facility | None | $97.72 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $97.72 Median $199.53 Typical High $363.08 | Professional | None | $97.72 | $199.53 | $363.08 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $562.34 | Professional | None | $134.90 | $199.53 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $177.83 Typical High $371.54 | Facility | None | $53.70 | $177.83 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $257.04 Typical High $446.68 | Professional | None | $131.83 | $257.04 | $446.68 |
Contra Costa Health Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $549.54 | Professional | None | $104.71 | $194.98 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $407.38 Typical High $758.58 | Professional | None | $151.36 | $407.38 | $758.58 |
Lucent Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,235.94 | Professional | None | $2,398.83 | $2,398.83 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $467.74 | Professional | None | $281.84 | $281.84 | $467.74 |
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 $58.88 Median $186.21 Typical High $524.81 | Facility | None | $58.88 | $186.21 | $524.81 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $257.04 Typical High $416.87 | Professional | None | $131.83 | $257.04 | $416.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,023.29 | Professional | None | $457.09 | $457.09 | $1,023.29 |
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 $112.20 Median $234.42 Typical High $537.03 | Professional | None | $112.20 | $234.42 | $537.03 |
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 $63.10 Median $67.61 Typical High $138.04 | Facility | 52 · Reduced service | $63.10 | $67.61 | $138.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $26.92 Typical High $54.95 | Facility | 53 · Discontinued | $25.12 | $26.92 | $54.95 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $93.33 Median $102.33 Typical High $208.93 | Facility | 54 · Surgery only | $93.33 | $102.33 | $208.93 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $41.69 | Facility | 55 · Aftercare only | $18.62 | $20.42 | $41.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.49 Typical High $27.54 | Facility | 56 · Pre-op care only | $12.59 | $13.49 | $27.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $95.50 Typical High $194.98 | Facility | 78 · Unplanned return to OR | $87.10 | $95.50 | $194.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $107.15 Typical High $138.04 | Professional | 52 · Reduced service | $58.88 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $42.66 Typical High $54.95 | Professional | 53 · Discontinued | $23.44 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $158.49 Typical High $208.93 | Professional | 54 · Surgery only | $87.10 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $31.62 Typical High $41.69 | Professional | 55 · Aftercare only | $17.38 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $21.38 Typical High $27.54 | Professional | 56 · Pre-op care only | $11.75 | $21.38 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $147.91 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $81.28 | $147.91 | $194.98 |
Where California sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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
$234
WI $603KY $166
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.