How much rates vary
Facilitymedian $1,820 · 10th to 90th $398 to $8,710Professionalmedian $380 · 10th to 90th $269 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 $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 $269.15 Median $398.11 Typical High $588.84 | Professional | None | $269.15 | $398.11 | $588.84 |
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 $295.12 Median $302.00 Typical High $891.25 | Professional | None | $295.12 | $302.00 | $891.25 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,621.81 Typical High $7,079.46 | Facility | None | $100.00 | $1,621.81 | $7,079.46 |
Blue Shield Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $537.03 | Professional | None | $218.78 | $331.13 | $537.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $616.60 | Professional | None | $269.15 | $363.08 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $588.84 Typical High $2,691.53 | Facility | None | $371.54 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $676.08 | Professional | None | $288.40 | $398.11 | $676.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $181.97 Median $354.81 Typical High $602.56 | Professional | None | $181.97 | $354.81 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $478.63 Typical High $851.14 | Professional | None | $281.84 | $478.63 | $851.14 |
Lucent Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,715.35 | Professional | None | $3,162.28 | $3,162.28 | $3,715.35 |
Molina Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $602.56 | Professional | None | $363.08 | $363.08 | $602.56 |
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 $354.81 Median $549.54 Typical High $2,398.83 | Facility | None | $354.81 | $549.54 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $630.96 | Professional | None | $288.40 | $398.11 | $630.96 |
Sutter Health Plus Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,479.11 | Professional | None | $933.25 | $933.25 | $1,479.11 |
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 $380.19 Typical High $707.95 | Professional | None | $229.09 | $380.19 | $707.95 |
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 $134.90 Median $144.54 Typical High $223.87 | Facility | 52 · Reduced service | $134.90 | $144.54 | $223.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $53.70 Median $57.54 Typical High $89.13 | Facility | 53 · Discontinued | $53.70 | $57.54 | $89.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $199.53 Median $218.78 Typical High $331.13 | Facility | 54 · Surgery only | $199.53 | $218.78 | $331.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $39.81 Median $43.65 Typical High $66.07 | Facility | 55 · Aftercare only | $39.81 | $43.65 | $66.07 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.84 Typical High $44.67 | Facility | 56 · Pre-op care only | $26.92 | $28.84 | $44.67 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $204.17 Typical High $309.03 | Facility | 78 · Unplanned return to OR | $186.21 | $204.17 | $309.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $177.83 Typical High $218.78 | Professional | 52 · Reduced service | $125.89 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $70.79 Typical High $89.13 | Professional | 53 · Discontinued | $50.12 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $263.03 Typical High $331.13 | Professional | 54 · Surgery only | $190.55 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $52.48 Typical High $66.07 | Professional | 55 · Aftercare only | $38.02 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $35.48 Typical High $43.65 | Professional | 56 · Pre-op care only | $25.12 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $245.47 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $177.83 | $245.47 | $309.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $575.44 Typical High $776.25 | Professional | 50 · Both sides | $426.58 | $575.44 | $776.25 |
Where California sits
The same service costs 4.7 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· 39th of 51
$398
AK $1,175UT $251
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.