How much rates vary
Facilitymedian $2,138 · 10th to 90th $646 to $8,913Professionalmedian $331 · 10th to 90th $251 to $1,230
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 $741.31 Median $6,606.93 Typical High $15,848.93 | Facility | None | $741.31 | $6,606.93 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $549.54 | Professional | None | $275.42 | $323.59 | $549.54 |
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 $263.03 Median $302.00 Typical High $794.33 | Professional | None | $263.03 | $302.00 | $794.33 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,659.59 Typical High $7,079.46 | Facility | None | $100.00 | $1,659.59 | $7,079.46 |
Blue Shield Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $446.68 | Professional | None | $229.09 | $331.13 | $446.68 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $446.68 | Professional | None | $251.19 | $354.81 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $2,884.03 | Facility | None | $645.65 | $1,380.38 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $501.19 | Professional | None | $288.40 | $331.13 | $501.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $436.52 | Professional | None | $194.98 | $346.74 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $776.25 | Professional | None | $275.42 | $354.81 | $776.25 |
Lucent Health Setting Professional Modifier None Typical Low $2,754.23 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,754.23 | $3,162.28 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $446.68 | Professional | None | $269.15 | $269.15 | $446.68 |
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 $436.52 Median $1,348.96 Typical High $5,128.61 | Facility | None | $436.52 | $1,348.96 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $501.19 | Professional | None | $288.40 | $331.13 | $501.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,047.13 | Professional | None | $933.25 | $933.25 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,090.30 | $10,964.78 |
United Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $524.81 | Professional | None | $229.09 | $302.00 | $524.81 |
12 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 $147.91 Typical High $165.96 | Facility | 52 · Reduced service | $134.90 | $147.91 | $165.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $54.95 Median $60.26 Typical High $66.07 | Facility | 53 · Discontinued | $54.95 | $60.26 | $66.07 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $204.17 Median $223.87 Typical High $251.19 | Facility | 54 · Surgery only | $204.17 | $223.87 | $251.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $50.12 | Facility | 55 · Aftercare only | $40.74 | $44.67 | $50.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $33.11 | Facility | 56 · Pre-op care only | $26.92 | $30.20 | $33.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $208.93 Typical High $234.42 | Facility | 78 · Unplanned return to OR | $190.55 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $144.54 Typical High $165.96 | Professional | 52 · Reduced service | $131.83 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $57.54 Typical High $66.07 | Professional | 53 · Discontinued | $52.48 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $218.78 Typical High $245.47 | Professional | 54 · Surgery only | $194.98 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $43.65 Typical High $48.98 | Professional | 55 · Aftercare only | $38.90 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.84 Typical High $33.11 | Professional | 56 · Pre-op care only | $26.30 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $204.17 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $181.97 | $204.17 | $229.09 |
Where California sits
The same service costs 6.8 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· 34th of 51
$331
AK $1,288UT $191
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.