How much rates vary
Facilitymedian $1,660 · 10th to 90th $550 to $7,943Professionalmedian $417 · 10th to 90th $295 to $1,122
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 $489.78 Median $5,754.40 Typical High $15,848.93 | Facility | None | $489.78 | $5,754.40 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $724.44 | Professional | None | $295.12 | $436.52 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $323.59 Typical High $912.01 | Professional | None | $309.03 | $323.59 | $912.01 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,584.89 Typical High $6,309.57 | Facility | None | $100.00 | $1,584.89 | $6,309.57 |
Blue Shield Setting Professional Modifier None Typical Low $257.04 Median $380.19 Typical High $562.34 | Professional | None | $257.04 | $380.19 | $562.34 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $323.59 Median $537.03 Typical High $645.65 | Professional | None | $323.59 | $537.03 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $2,454.71 | Facility | None | $575.44 | $1,174.90 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $724.44 | Professional | None | $316.23 | $446.68 | $724.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $630.96 | Professional | None | $346.74 | $436.52 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $512.86 Typical High $933.25 | Professional | None | $309.03 | $512.86 | $933.25 |
Lucent Health Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,890.45 | Professional | None | $3,311.31 | $3,311.31 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $645.65 | Professional | None | $389.05 | $389.05 | $645.65 |
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 $467.74 Median $1,148.15 Typical High $3,801.89 | Facility | None | $467.74 | $1,148.15 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $676.08 | Professional | None | $316.23 | $446.68 | $676.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,023.29 | $1,584.89 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $758.58 | Professional | None | $251.19 | $407.38 | $758.58 |
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 $147.91 Median $158.49 Typical High $245.47 | Facility | 52 · Reduced service | $147.91 | $158.49 | $245.47 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $58.88 Median $64.57 Typical High $97.72 | Facility | 53 · Discontinued | $58.88 | $64.57 | $97.72 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $223.87 Median $239.88 Typical High $363.08 | Facility | 54 · Surgery only | $223.87 | $239.88 | $363.08 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $44.67 Median $47.86 Typical High $72.44 | Facility | 55 · Aftercare only | $44.67 | $47.86 | $72.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $29.51 Median $31.62 Typical High $48.98 | Facility | 56 · Pre-op care only | $29.51 | $31.62 | $48.98 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $223.87 Typical High $338.84 | Facility | 78 · Unplanned return to OR | $208.93 | $223.87 | $338.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $194.98 Typical High $239.88 | Professional | 52 · Reduced service | $141.25 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $77.62 Typical High $95.50 | Professional | 53 · Discontinued | $56.23 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $288.40 Typical High $363.08 | Professional | 54 · Surgery only | $208.93 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $57.54 Typical High $72.44 | Professional | 55 · Aftercare only | $41.69 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $38.90 Typical High $47.86 | Professional | 56 · Pre-op care only | $28.18 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $269.15 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $194.98 | $269.15 | $338.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $616.60 Typical High $851.14 | Professional | 50 · Both sides | $467.74 | $616.60 | $851.14 |
Where California sits
The same service costs 4.9 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· 38th of 51
$437
AK $1,413UT $288
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.