How much rates vary
Facilitymedian $3,090 · 10th to 90th $832 to $10,965Professionalmedian $631 · 10th to 90th $468 to $2,884
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 $446.68 Median $562.34 Typical High $691.83 | Professional | None | $446.68 | $562.34 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,128.31 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $524.81 Typical High $1,621.81 | Professional | None | $512.86 | $524.81 | $1,621.81 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,398.83 Typical High $9,120.11 | Facility | None | $100.00 | $2,398.83 | $9,120.11 |
Blue Shield Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $870.96 | Professional | None | $436.52 | $630.96 | $870.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $912.01 | Professional | None | $478.63 | $741.31 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,570.40 Typical High $5,011.87 | Facility | None | $758.58 | $2,570.40 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $1,023.29 | Professional | None | $489.78 | $660.69 | $1,023.29 |
Contra Costa Health Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $870.96 | Professional | None | $524.81 | $645.65 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $1,445.44 | Professional | None | $467.74 | $707.95 | $1,445.44 |
Lucent Health Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,495.41 | Professional | None | $4,786.30 | $4,786.30 | $5,495.41 |
Molina Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $933.25 | Professional | None | $562.34 | $562.34 | $933.25 |
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 $676.08 Median $2,454.71 Typical High $5,495.41 | Facility | None | $676.08 | $2,454.71 | $5,495.41 |
Providence Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $977.24 | Professional | None | $489.78 | $645.65 | $977.24 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,621.81 | $1,621.81 | $2,238.72 |
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 $398.11 Median $588.84 Typical High $1,071.52 | Professional | None | $398.11 | $588.84 | $1,071.52 |
12 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 $229.09 Median $245.47 Typical High $346.74 | Facility | 52 · Reduced service | $229.09 | $245.47 | $346.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $93.33 Median $100.00 Typical High $138.04 | Facility | 53 · Discontinued | $93.33 | $100.00 | $138.04 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $346.74 Median $371.54 Typical High $512.86 | Facility | 54 · Surgery only | $346.74 | $371.54 | $512.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $69.18 Median $74.13 Typical High $104.71 | Facility | 55 · Aftercare only | $69.18 | $74.13 | $104.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $46.77 Median $50.12 Typical High $69.18 | Facility | 56 · Pre-op care only | $46.77 | $50.12 | $69.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $346.74 Typical High $478.63 | Facility | 78 · Unplanned return to OR | $323.59 | $346.74 | $478.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $281.84 Typical High $338.84 | Professional | 52 · Reduced service | $218.78 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $112.20 Typical High $134.90 | Professional | 53 · Discontinued | $89.13 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $416.87 Typical High $501.19 | Professional | 54 · Surgery only | $331.13 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $83.18 Typical High $100.00 | Professional | 55 · Aftercare only | $66.07 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $56.23 Typical High $67.61 | Professional | 56 · Pre-op care only | $44.67 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $389.05 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $309.03 | $389.05 | $467.74 |
Where California sits
The same service costs 5.8 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· 39th of 51
$646
AK $2,455TX $427
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.