How much rates vary
Facilitymedian $1,445 · 10th to 90th $372 to $6,310Professionalmedian $234 · 10th to 90th $158 to $1,023
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 $165.96 Median $257.04 Typical High $416.87 | Professional | None | $165.96 | $257.04 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $2,137.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $537.03 | Professional | None | $169.82 | $204.17 | $537.03 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,348.96 Typical High $4,786.30 | Facility | None | $100.00 | $1,348.96 | $4,786.30 |
Blue Shield Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $316.23 | Professional | None | $128.82 | $190.55 | $316.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $398.11 | Professional | None | $154.88 | $208.93 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,148.15 Typical High $2,238.72 | Facility | None | $426.58 | $1,148.15 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $426.58 | Professional | None | $173.78 | $251.19 | $426.58 |
Contra Costa Health Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $389.05 | Professional | None | $125.89 | $208.93 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $295.12 Typical High $562.34 | Professional | None | $165.96 | $295.12 | $562.34 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,949.84 | $1,949.84 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $380.19 | Professional | None | $229.09 | $229.09 | $380.19 |
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 $323.59 Median $1,122.02 Typical High $2,818.38 | Facility | None | $323.59 | $1,122.02 | $2,818.38 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $389.05 | Professional | None | $165.96 | $251.19 | $389.05 |
Sutter Health Plus Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $912.01 | Professional | None | $575.44 | $575.44 | $912.01 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,230.27 Typical High $4,677.35 | Facility | None | $398.11 | $1,230.27 | $4,677.35 |
United Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $457.09 | Professional | None | $141.25 | $234.42 | $457.09 |
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 $83.18 Median $89.13 Typical High $141.25 | Facility | 52 · Reduced service | $83.18 | $89.13 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.11 Median $35.48 Typical High $57.54 | Facility | 53 · Discontinued | $33.11 | $35.48 | $57.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $125.89 Median $134.90 Typical High $213.80 | Facility | 54 · Surgery only | $125.89 | $134.90 | $213.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.12 Median $26.92 Typical High $42.66 | Facility | 55 · Aftercare only | $25.12 | $26.92 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.60 Median $17.78 Typical High $28.18 | Facility | 56 · Pre-op care only | $16.60 | $17.78 | $28.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $125.89 Typical High $199.53 | Facility | 78 · Unplanned return to OR | $117.49 | $125.89 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $112.20 Typical High $138.04 | Professional | 52 · Reduced service | $77.62 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $44.67 Typical High $54.95 | Professional | 53 · Discontinued | $30.90 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $169.82 Typical High $208.93 | Professional | 54 · Surgery only | $117.49 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $33.88 Typical High $41.69 | Professional | 55 · Aftercare only | $23.44 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $22.39 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.49 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $158.49 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $109.65 | $158.49 | $194.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $263.03 Median $346.74 Typical High $478.63 | Professional | 50 · Both sides | $263.03 | $346.74 | $478.63 |
Where California sits
The same service costs 4.1 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· 40th of 51
$245
AK $851TX $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.