How much rates vary
Facilitymedian $1,380 · 10th to 90th $240 to $6,457Professionalmedian $209 · 10th to 90th $126 to $562
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 $269.15 Median $5,754.40 Typical High $15,848.93 | Facility | None | $269.15 | $5,754.40 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $338.84 | Professional | None | $125.89 | $213.80 | $338.84 |
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 $117.49 Median $138.04 Typical High $446.68 | Professional | None | $117.49 | $138.04 | $446.68 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $1,513.56 Typical High $5,011.87 | Facility | None | $97.72 | $1,513.56 | $5,011.87 |
Blue Shield Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $295.12 | Professional | None | $107.15 | $173.78 | $295.12 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $346.74 | Professional | None | $138.04 | $186.21 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $346.74 Typical High $1,412.54 | Facility | None | $223.87 | $346.74 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $389.05 | Professional | None | $134.90 | $218.78 | $389.05 |
Contra Costa Health Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $338.84 | Professional | None | $123.03 | $165.96 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $257.04 Typical High $501.19 | Professional | None | $131.83 | $257.04 | $501.19 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,041.74 | Professional | None | $1,949.84 | $1,949.84 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $331.13 | Professional | None | $199.53 | $199.53 | $331.13 |
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 $208.93 Median $363.08 Typical High $2,454.71 | Facility | None | $208.93 | $363.08 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $354.81 | Professional | None | $131.83 | $218.78 | $354.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $851.14 | Professional | None | $436.52 | $436.52 | $851.14 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $4,677.35 | Facility | None | $398.11 | $1,202.26 | $4,677.35 |
United Setting Professional Modifier None Typical Low $107.15 Median $208.93 Typical High $407.38 | Professional | None | $107.15 | $208.93 | $407.38 |
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 $61.66 Median $67.61 Typical High $131.83 | Facility | 52 · Reduced service | $61.66 | $67.61 | $131.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $26.92 Typical High $53.70 | Facility | 53 · Discontinued | $25.12 | $26.92 | $53.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $93.33 Median $100.00 Typical High $199.53 | Facility | 54 · Surgery only | $93.33 | $100.00 | $199.53 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $39.81 | Facility | 55 · Aftercare only | $18.62 | $20.42 | $39.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.49 Typical High $26.92 | Facility | 56 · Pre-op care only | $12.59 | $13.49 | $26.92 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $93.33 Typical High $186.21 | Facility | 78 · Unplanned return to OR | $87.10 | $93.33 | $186.21 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $104.71 Typical High $125.89 | Professional | 52 · Reduced service | $58.88 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $41.69 Typical High $51.29 | Professional | 53 · Discontinued | $23.44 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $154.88 Typical High $190.55 | Professional | 54 · Surgery only | $89.13 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $30.90 Typical High $38.02 | Professional | 55 · Aftercare only | $17.78 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $20.89 Typical High $25.70 | Professional | 56 · Pre-op care only | $11.75 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $144.54 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $83.18 | $144.54 | $177.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $199.53 Median $309.03 Typical High $380.19 | Professional | 50 · Both sides | $199.53 | $309.03 | $380.19 |
Where California sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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
$219
AK $617KY $170
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.