How much rates vary
Facilitymedian $437 · 10th to 90th $129 to $5,623Professionalmedian $257 · 10th to 90th $200 to $891
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 $478.63 Median $5,128.61 Typical High $15,135.61 | Facility | None | $478.63 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $478.63 | Professional | None | $199.53 | $239.88 | $478.63 |
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 $229.09 Median $234.42 Typical High $660.69 | Professional | None | $229.09 | $234.42 | $660.69 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $426.58 Typical High $1,445.44 | Facility | None | $100.00 | $426.58 | $1,445.44 |
Blue Shield Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $371.54 | Professional | None | $190.55 | $275.42 | $371.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $389.05 | Professional | None | $199.53 | $302.00 | $389.05 |
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 $229.09 Median $263.03 Typical High $407.38 | Professional | None | $229.09 | $263.03 | $407.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $154.88 Median $302.00 Typical High $380.19 | Professional | None | $154.88 | $302.00 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $676.08 | Professional | None | $234.42 | $309.03 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,949.84 | $1,949.84 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $380.19 | Professional | None | $223.87 | $223.87 | $380.19 |
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 $245.47 Typical High $537.03 | Facility | None | $61.66 | $245.47 | $537.03 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $407.38 | Professional | None | $229.09 | $263.03 | $407.38 |
Sutter Health Plus Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $851.14 | Professional | None | $741.31 | $741.31 | $851.14 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $436.52 | Professional | None | $181.97 | $239.88 | $436.52 |
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 $104.71 Median $117.49 Typical High $131.83 | Facility | 52 · Reduced service | $104.71 | $117.49 | $131.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $46.77 Typical High $52.48 | Facility | 53 · Discontinued | $41.69 | $46.77 | $52.48 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $173.78 Typical High $194.98 | Facility | 54 · Surgery only | $158.49 | $173.78 | $194.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $34.67 Typical High $38.90 | Facility | 55 · Aftercare only | $31.62 | $34.67 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.44 Typical High $26.30 | Facility | 56 · Pre-op care only | $20.89 | $23.44 | $26.30 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $162.18 Typical High $181.97 | Facility | 78 · Unplanned return to OR | $147.91 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $114.82 Typical High $131.83 | Professional | 52 · Reduced service | $100.00 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $45.71 Typical High $52.48 | Professional | 53 · Discontinued | $39.81 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $173.78 Typical High $194.98 | Professional | 54 · Surgery only | $151.36 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $34.67 Typical High $38.90 | Professional | 55 · Aftercare only | $30.20 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $22.91 Typical High $26.30 | Professional | 56 · Pre-op care only | $19.95 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $162.18 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $141.25 | $162.18 | $181.97 |
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
$263
AK $955UT $186
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.