How much rates vary
Facilitymedian $417 · 10th to 90th $120 to $5,495Professionalmedian $288 · 10th to 90th $214 to $776
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 $269.15 Median $6,760.83 Typical High $18,197.01 | Facility | None | $269.15 | $6,760.83 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $524.81 | Professional | None | $239.88 | $288.40 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
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 $239.88 Median $288.40 Typical High $741.31 | Professional | None | $239.88 | $288.40 | $741.31 |
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 $147.91 Median $218.78 Typical High $309.03 | Professional | None | $147.91 | $218.78 | $309.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $181.97 Median $426.58 Typical High $489.78 | Professional | None | $181.97 | $426.58 | $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 $223.87 Median $295.12 Typical High $478.63 | Professional | None | $223.87 | $295.12 | $478.63 |
Contra Costa Health Setting Professional Modifier None Typical Low $138.04 Median $416.87 Typical High $478.63 | Professional | None | $138.04 | $416.87 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $851.14 | Professional | None | $316.23 | $407.38 | $851.14 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,951.21 | Professional | None | $2,290.87 | $2,290.87 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $436.52 | Professional | None | $263.03 | $263.03 | $436.52 |
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 $245.47 Typical High $549.54 | Facility | None | $61.66 | $245.47 | $549.54 |
Providence Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $467.74 | Professional | None | $223.87 | $295.12 | $467.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $977.24 | Professional | None | $933.25 | $933.25 | $977.24 |
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 $213.80 Median $263.03 Typical High $512.86 | Professional | None | $213.80 | $263.03 | $512.86 |
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 $114.82 Median $131.83 Typical High $144.54 | Facility | 52 · Reduced service | $114.82 | $131.83 | $144.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $45.71 Median $52.48 Typical High $58.88 | Facility | 53 · Discontinued | $45.71 | $52.48 | $58.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $173.78 Median $199.53 Typical High $218.78 | Facility | 54 · Surgery only | $173.78 | $199.53 | $218.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $34.67 Median $39.81 Typical High $43.65 | Facility | 55 · Aftercare only | $34.67 | $39.81 | $43.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.30 Typical High $28.84 | Facility | 56 · Pre-op care only | $22.91 | $26.30 | $28.84 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $186.21 Typical High $204.17 | Facility | 78 · Unplanned return to OR | $162.18 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $131.83 Typical High $144.54 | Professional | 52 · Reduced service | $114.82 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $52.48 Typical High $58.88 | Professional | 53 · Discontinued | $45.71 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $199.53 Typical High $218.78 | Professional | 54 · Surgery only | $169.82 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $39.81 Typical High $43.65 | Professional | 55 · Aftercare only | $33.88 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.30 Typical High $28.84 | Professional | 56 · Pre-op care only | $22.91 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $186.21 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $158.49 | $186.21 | $204.17 |
Where California sits
The same service costs 5.6 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· 41st of 51
$288
AK $1,230TX $219
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.