How much rates vary
Facilitymedian $1,000 · 10th to 90th $170 to $6,310Professionalmedian $316 · 10th to 90th $245 to $977
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 $257.04 Median $309.03 Typical High $537.03 | Professional | None | $257.04 | $309.03 | $537.03 |
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 $316.23 Median $316.23 Typical High $851.14 | Professional | None | $316.23 | $316.23 | $851.14 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,412.54 Typical High $5,248.07 | Facility | None | $100.00 | $1,412.54 | $5,248.07 |
Blue Shield Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $416.87 | Professional | None | $199.53 | $288.40 | $416.87 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $524.81 | Professional | None | $302.00 | $436.52 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $295.12 Typical High $812.83 | Facility | None | $181.97 | $295.12 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $512.86 | Professional | None | $275.42 | $331.13 | $512.86 |
Contra Costa Health Setting Professional Modifier None Typical Low $177.83 Median $426.58 Typical High $512.86 | Professional | None | $177.83 | $426.58 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $912.01 | Professional | None | $331.13 | $426.58 | $912.01 |
Lucent Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,235.94 | Professional | None | $2,454.71 | $2,454.71 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $478.63 | Professional | None | $288.40 | $288.40 | $478.63 |
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 $190.55 Median $389.05 Typical High $2,454.71 | Facility | None | $190.55 | $389.05 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $512.86 | Professional | None | $275.42 | $316.23 | $512.86 |
Sutter Health Plus Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,071.52 | Professional | None | $977.24 | $977.24 | $1,071.52 |
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 $229.09 Median $288.40 Typical High $562.34 | Professional | None | $229.09 | $288.40 | $562.34 |
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 $128.82 Median $144.54 Typical High $162.18 | Facility | 52 · Reduced service | $128.82 | $144.54 | $162.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $51.29 Median $58.88 Typical High $64.57 | Facility | 53 · Discontinued | $51.29 | $58.88 | $64.57 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $194.98 Median $218.78 Typical High $245.47 | Facility | 54 · Surgery only | $194.98 | $218.78 | $245.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.90 Median $43.65 Typical High $48.98 | Facility | 55 · Aftercare only | $38.90 | $43.65 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.84 Typical High $32.36 | Facility | 56 · Pre-op care only | $25.70 | $28.84 | $32.36 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $204.17 Typical High $229.09 | Facility | 78 · Unplanned return to OR | $181.97 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $144.54 Typical High $162.18 | Professional | 52 · Reduced service | $123.03 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $58.88 Typical High $64.57 | Professional | 53 · Discontinued | $50.12 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $218.78 Typical High $245.47 | Professional | 54 · Surgery only | $186.21 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $43.65 Typical High $48.98 | Professional | 55 · Aftercare only | $37.15 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $28.84 Typical High $32.36 | Professional | 56 · Pre-op care only | $24.55 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $204.17 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $173.78 | $204.17 | $229.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $501.19 Typical High $812.83 | Professional | 50 · Both sides | $407.38 | $501.19 | $812.83 |
Where California sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$324
AK $1,259UT $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.