How much rates vary
Facilitymedian $1,000 · 10th to 90th $170 to $6,310Professionalmedian $490 · 10th to 90th $372 to $1,905
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 $407.38 Median $436.52 Typical High $630.96 | Professional | None | $407.38 | $436.52 | $630.96 |
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 $398.11 Median $489.78 Typical High $1,230.27 | Professional | None | $398.11 | $489.78 | $1,230.27 |
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 $316.23 Median $467.74 Typical High $630.96 | Professional | None | $316.23 | $467.74 | $630.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $776.25 | Professional | None | $501.19 | $616.60 | $776.25 |
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 $416.87 Median $478.63 Typical High $758.58 | Professional | None | $416.87 | $478.63 | $758.58 |
Contra Costa Health Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $741.31 | Professional | None | $457.09 | $602.56 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,318.26 | Professional | None | $467.74 | $616.60 | $1,318.26 |
Lucent Health Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,677.35 | Professional | None | $3,630.78 | $3,630.78 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $707.95 | Professional | None | $426.58 | $426.58 | $707.95 |
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 $478.63 Typical High $2,454.71 | Facility | None | $190.55 | $478.63 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $741.31 | Professional | None | $416.87 | $467.74 | $741.31 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,584.89 | Professional | None | $1,445.44 | $1,445.44 | $1,584.89 |
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 $346.74 Median $436.52 Typical High $812.83 | Professional | None | $346.74 | $436.52 | $812.83 |
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 $190.55 Median $218.78 Typical High $234.42 | Facility | 52 · Reduced service | $190.55 | $218.78 | $234.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $75.86 Median $87.10 Typical High $95.50 | Facility | 53 · Discontinued | $75.86 | $87.10 | $95.50 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $288.40 Median $323.59 Typical High $354.81 | Facility | 54 · Surgery only | $288.40 | $323.59 | $354.81 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $57.54 Median $64.57 Typical High $70.79 | Facility | 55 · Aftercare only | $57.54 | $64.57 | $70.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $38.02 Median $43.65 Typical High $46.77 | Facility | 56 · Pre-op care only | $38.02 | $43.65 | $46.77 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $302.00 Typical High $331.13 | Facility | 78 · Unplanned return to OR | $269.15 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $218.78 Typical High $234.42 | Professional | 52 · Reduced service | $190.55 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $87.10 Typical High $95.50 | Professional | 53 · Discontinued | $75.86 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $323.59 Typical High $354.81 | Professional | 54 · Surgery only | $281.84 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $64.57 Typical High $70.79 | Professional | 55 · Aftercare only | $56.23 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $43.65 Typical High $46.77 | Professional | 56 · Pre-op care only | $38.02 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $302.00 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $263.03 | $302.00 | $331.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $707.95 Typical High $1,174.90 | Professional | 50 · Both sides | $549.54 | $707.95 | $1,174.90 |
Where California sits
The same service costs 4.9 times more in Connecticut than in Florida. 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
CT $3,107FL $640
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.