How much rates vary
Facilitymedian $3,020 · 10th to 90th $933 to $12,023Professionalmedian $617 · 10th to 90th $457 to $4,266
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 $1,548.82 Median $7,413.10 Typical High $18,620.87 | Facility | None | $1,548.82 | $7,413.10 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $912.01 | Professional | None | $489.78 | $575.44 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,128.31 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $1,445.44 | Professional | None | $562.34 | $630.96 | $1,445.44 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,630.27 Typical High $10,715.19 | Facility | None | $100.00 | $2,630.27 | $10,715.19 |
Blue Shield Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $660.69 | Professional | None | $323.59 | $478.63 | $660.69 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $741.31 | Professional | None | $446.68 | $630.96 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,570.40 Typical High $5,011.87 | Facility | None | $758.58 | $2,570.40 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $954.99 | Professional | None | $446.68 | $575.44 | $954.99 |
Contra Costa Health Setting Professional Modifier None Typical Low $295.12 Median $660.69 Typical High $812.83 | Professional | None | $295.12 | $660.69 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $1,479.11 | Professional | None | $562.34 | $676.08 | $1,479.11 |
Lucent Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,786.30 | Professional | None | $4,265.80 | $4,265.80 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
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 $707.95 Median $2,570.40 Typical High $6,606.93 | Facility | None | $707.95 | $2,570.40 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $891.25 | Professional | None | $446.68 | $575.44 | $891.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $14,454.40 | Facility | None | $933.25 | $1,905.46 | $14,454.40 |
United Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $954.99 | Professional | None | $446.68 | $562.34 | $954.99 |
6 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 Professional Modifier 52 · Reduced service Typical Low $245.47 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $426.58 | Professional | 54 · Surgery only | $363.08 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $363.08 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $338.84 | $363.08 | $398.11 |
Where California sits
The same service costs 4.7 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $8,820MT $1,888
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.