How much rates vary
Facilitymedian $603 · 10th to 90th $148 to $5,012Professionalmedian $214 · 10th to 90th $166 to $575
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 $4,897.79 Typical High $15,135.61 | Facility | None | $269.15 | $4,897.79 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $380.19 | Professional | None | $173.78 | $213.80 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $181.97 Median $186.21 Typical High $549.54 | Professional | None | $181.97 | $186.21 | $549.54 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $1,479.11 | Facility | None | $97.72 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $288.40 | Professional | None | $138.04 | $204.17 | $288.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $338.84 | Professional | None | $181.97 | $295.12 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $218.78 Typical High $457.09 | Facility | None | $53.70 | $218.78 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $346.74 | Professional | None | $186.21 | $223.87 | $346.74 |
Contra Costa Health Setting Professional Modifier None Typical Low $138.04 Median $288.40 Typical High $331.13 | Professional | None | $138.04 | $288.40 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $588.84 | Professional | None | $218.78 | $281.84 | $588.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,621.81 | $1,621.81 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $316.23 | Professional | None | $190.55 | $190.55 | $316.23 |
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 $61.66 Median $239.88 Typical High $489.78 | Facility | None | $61.66 | $239.88 | $489.78 |
Providence Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $346.74 | Professional | None | $186.21 | $218.78 | $346.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $724.44 | Professional | None | $676.08 | $676.08 | $724.44 |
United Setting Facility Modifier None Typical Low $147.91 Median $602.56 Typical High $1,778.28 | Facility | None | $147.91 | $602.56 | $1,778.28 |
United Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $380.19 | Professional | None | $158.49 | $199.53 | $380.19 |
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 $85.11 Median $95.50 Typical High $107.15 | Facility | 52 · Reduced service | $85.11 | $95.50 | $107.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $34.67 Median $38.90 Typical High $43.65 | Facility | 53 · Discontinued | $34.67 | $38.90 | $43.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $128.82 Median $144.54 Typical High $162.18 | Facility | 54 · Surgery only | $128.82 | $144.54 | $162.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $28.84 Typical High $32.36 | Facility | 55 · Aftercare only | $25.70 | $28.84 | $32.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.05 Typical High $21.88 | Facility | 56 · Pre-op care only | $17.38 | $19.05 | $21.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $134.90 Typical High $151.36 | Facility | 78 · Unplanned return to OR | $120.23 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $95.50 Typical High $107.15 | Professional | 52 · Reduced service | $81.28 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $38.90 Typical High $43.65 | Professional | 53 · Discontinued | $33.11 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $144.54 Typical High $162.18 | Professional | 54 · Surgery only | $123.03 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $28.84 Typical High $32.36 | Professional | 55 · Aftercare only | $24.55 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.05 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.22 | $19.05 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $134.90 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $114.82 | $134.90 | $151.36 |
Where California sits
The same service costs 5.1 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
$219
AK $871UT $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.