How much rates vary
Facilitymedian $2,754 · 10th to 90th $575 to $9,120Professionalmedian $331 · 10th to 90th $229 to $1,622
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 $645.65 Median $5,888.44 Typical High $15,848.93 | Facility | None | $645.65 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $407.38 | Professional | None | $218.78 | $316.23 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,606.93 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $257.04 Typical High $741.31 | Professional | None | $251.19 | $257.04 | $741.31 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,187.76 Typical High $6,918.31 | Facility | None | $100.00 | $2,187.76 | $6,918.31 |
Blue Shield Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $457.09 | Professional | None | $218.78 | $323.59 | $457.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $512.86 | Professional | None | $239.88 | $302.00 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,454.71 Typical High $4,786.30 | Facility | None | $575.44 | $2,454.71 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $588.84 | Professional | None | $239.88 | $363.08 | $588.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $158.49 Median $295.12 Typical High $501.19 | Professional | None | $158.49 | $295.12 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $758.58 | Professional | None | $234.42 | $398.11 | $758.58 |
Lucent Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,090.30 | Professional | None | $2,630.27 | $2,630.27 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $512.86 | Professional | None | $309.03 | $309.03 | $512.86 |
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 $446.68 Median $2,238.72 Typical High $5,128.61 | Facility | None | $446.68 | $2,238.72 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $537.03 | Professional | None | $239.88 | $363.08 | $537.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,258.93 | Professional | None | $776.25 | $776.25 | $1,258.93 |
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 $190.55 Median $323.59 Typical High $602.56 | Professional | None | $190.55 | $323.59 | $602.56 |
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 $114.82 Median $125.89 Typical High $199.53 | Facility | 52 · Reduced service | $114.82 | $125.89 | $199.53 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $45.71 Median $50.12 Typical High $81.28 | Facility | 53 · Discontinued | $45.71 | $50.12 | $81.28 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $173.78 Median $186.21 Typical High $302.00 | Facility | 54 · Surgery only | $173.78 | $186.21 | $302.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $34.67 Median $37.15 Typical High $60.26 | Facility | 55 · Aftercare only | $34.67 | $37.15 | $60.26 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.12 Typical High $40.74 | Facility | 56 · Pre-op care only | $22.91 | $25.12 | $40.74 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $173.78 Typical High $281.84 | Facility | 78 · Unplanned return to OR | $162.18 | $173.78 | $281.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $158.49 Typical High $190.55 | Professional | 52 · Reduced service | $109.65 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $63.10 Typical High $75.86 | Professional | 53 · Discontinued | $43.65 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $239.88 Typical High $288.40 | Professional | 54 · Surgery only | $162.18 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $32.36 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $31.62 Typical High $38.02 | Professional | 56 · Pre-op care only | $21.88 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $223.87 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $151.36 | $223.87 | $269.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $501.19 Typical High $676.08 | Professional | 50 · Both sides | $354.81 | $501.19 | $676.08 |
Where California sits
The same service costs 5.5 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· 38th of 51
$347
AK $1,202TX $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.