How much rates vary
Facilitymedian $1,318 · 10th to 90th $550 to $8,318Professionalmedian $468 · 10th to 90th $339 to $1,660
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 $691.83 Median $7,244.36 Typical High $17,782.79 | Facility | None | $691.83 | $7,244.36 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $602.56 | Professional | None | $346.74 | $467.74 | $602.56 |
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 $346.74 Median $389.05 Typical High $1,023.29 | Professional | None | $346.74 | $389.05 | $1,023.29 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,548.82 Typical High $8,709.64 | Facility | None | $100.00 | $1,548.82 | $8,709.64 |
Blue Shield Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $660.69 | Professional | None | $288.40 | $416.87 | $660.69 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $724.44 | Professional | None | $331.13 | $446.68 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,230.27 Typical High $2,818.38 | Facility | None | $758.58 | $1,230.27 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $812.83 | Professional | None | $371.54 | $501.19 | $812.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $218.78 Median $446.68 Typical High $707.95 | Professional | None | $218.78 | $446.68 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $562.34 Typical High $1,071.52 | Professional | None | $354.81 | $562.34 | $1,071.52 |
Lucent Health Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,365.16 | Professional | None | $3,801.89 | $3,801.89 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $724.44 | Professional | None | $436.52 | $436.52 | $724.44 |
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 $602.56 Median $1,202.26 Typical High $4,570.88 | Facility | None | $602.56 | $1,202.26 | $4,570.88 |
Providence Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $758.58 | Professional | None | $371.54 | $501.19 | $758.58 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,230.27 | $1,778.28 |
United Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $3,090.30 | Facility | None | $446.68 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $831.76 | Professional | None | $295.12 | $457.09 | $831.76 |
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 $173.78 Median $186.21 Typical High $275.42 | Facility | 52 · Reduced service | $173.78 | $186.21 | $275.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $69.18 Median $74.13 Typical High $109.65 | Facility | 53 · Discontinued | $69.18 | $74.13 | $109.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $263.03 Median $281.84 Typical High $407.38 | Facility | 54 · Surgery only | $263.03 | $281.84 | $407.38 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $52.48 Median $56.23 Typical High $81.28 | Facility | 55 · Aftercare only | $52.48 | $56.23 | $81.28 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $34.67 Median $37.15 Typical High $54.95 | Facility | 56 · Pre-op care only | $34.67 | $37.15 | $54.95 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $263.03 Typical High $380.19 | Facility | 78 · Unplanned return to OR | $245.47 | $263.03 | $380.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $218.78 Typical High $269.15 | Professional | 52 · Reduced service | $165.96 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $87.10 Typical High $107.15 | Professional | 53 · Discontinued | $66.07 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $331.13 Typical High $398.11 | Professional | 54 · Surgery only | $245.47 | $331.13 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $66.07 Typical High $81.28 | Professional | 55 · Aftercare only | $48.98 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $43.65 Typical High $53.70 | Professional | 56 · Pre-op care only | $33.11 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $309.03 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $229.09 | $309.03 | $371.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $724.44 Typical High $977.24 | Professional | 50 · Both sides | $549.54 | $724.44 | $977.24 |
Where California sits
The same service costs 4.8 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· 35th of 51
$501
AK $1,549UT $324
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.