How much rates vary
Facilitymedian $1,000 · 10th to 90th $170 to $6,310Professionalmedian $331 · 10th to 90th $257 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 $275.42 Median $309.03 Typical High $549.54 | Professional | None | $275.42 | $309.03 | $549.54 |
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 $309.03 Median $331.13 Typical High $831.76 | Professional | None | $309.03 | $331.13 | $831.76 |
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 $208.93 Median $302.00 Typical High $436.52 | Professional | None | $208.93 | $302.00 | $436.52 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $229.09 Median $446.68 Typical High $537.03 | Professional | None | $229.09 | $446.68 | $537.03 |
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 $288.40 Median $338.84 Typical High $524.81 | Professional | None | $288.40 | $338.84 | $524.81 |
Contra Costa Health Setting Professional Modifier None Typical Low $177.83 Median $436.52 Typical High $524.81 | Professional | None | $177.83 | $436.52 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $933.25 | Professional | None | $338.84 | $436.52 | $933.25 |
Lucent Health Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,235.94 | Professional | None | $2,511.89 | $2,511.89 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $489.78 | Professional | None | $295.12 | $295.12 | $489.78 |
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 $398.11 Typical High $2,454.71 | Facility | None | $190.55 | $398.11 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $524.81 | Professional | None | $288.40 | $331.13 | $524.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,096.48 | Professional | None | $1,023.29 | $1,023.29 | $1,096.48 |
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 $239.88 Median $302.00 Typical High $575.44 | Professional | None | $239.88 | $302.00 | $575.44 |
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 $134.90 Median $151.36 Typical High $169.82 | Facility | 52 · Reduced service | $134.90 | $151.36 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $53.70 Median $60.26 Typical High $67.61 | Facility | 53 · Discontinued | $53.70 | $60.26 | $67.61 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $199.53 Median $229.09 Typical High $251.19 | Facility | 54 · Surgery only | $199.53 | $229.09 | $251.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $39.81 Median $45.71 Typical High $50.12 | Facility | 55 · Aftercare only | $39.81 | $45.71 | $50.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $33.88 | Facility | 56 · Pre-op care only | $26.92 | $30.20 | $33.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $213.80 Typical High $234.42 | Facility | 78 · Unplanned return to OR | $186.21 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $151.36 Typical High $169.82 | Professional | 52 · Reduced service | $128.82 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $60.26 Typical High $67.61 | Professional | 53 · Discontinued | $51.29 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $229.09 Typical High $251.19 | Professional | 54 · Surgery only | $194.98 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $45.71 Typical High $50.12 | Professional | 55 · Aftercare only | $38.90 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $30.20 Typical High $33.88 | Professional | 56 · Pre-op care only | $25.70 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $213.80 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $181.97 | $213.80 | $234.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $512.86 Typical High $831.76 | Professional | 50 · Both sides | $407.38 | $512.86 | $831.76 |
Where California sits
The same service costs 5.9 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· 41st of 51
$331
AK $1,288UT $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.