How much rates vary
Facilitymedian $437 · 10th to 90th $126 to $5,623Professionalmedian $166 · 10th to 90th $129 to $589
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 $181.97 Median $5,011.87 Typical High $15,135.61 | Facility | None | $181.97 | $5,011.87 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $331.13 | Professional | None | $141.25 | $169.82 | $331.13 |
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 $131.83 Median $147.91 Typical High $389.05 | Professional | None | $131.83 | $147.91 | $389.05 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $426.58 Typical High $1,412.54 | Facility | None | $100.00 | $426.58 | $1,412.54 |
Blue Shield Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $223.87 | Professional | None | $112.20 | $162.18 | $223.87 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $85.11 Median $218.78 Typical High $281.84 | Professional | None | $85.11 | $218.78 | $281.84 |
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 $144.54 Median $177.83 Typical High $281.84 | Professional | None | $144.54 | $177.83 | $281.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $66.07 Median $213.80 Typical High $275.42 | Professional | None | $66.07 | $213.80 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $489.78 | Professional | None | $162.18 | $223.87 | $489.78 |
Lucent Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,348.96 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $257.04 | Professional | None | $154.88 | $154.88 | $257.04 |
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 $218.78 Typical High $467.74 | Facility | None | $61.66 | $218.78 | $467.74 |
Providence Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $275.42 | Professional | None | $144.54 | $173.78 | $275.42 |
Sutter Health Plus Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $588.84 | Professional | None | $489.78 | $489.78 | $588.84 |
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 $120.23 Median $154.88 Typical High $316.23 | Professional | None | $120.23 | $154.88 | $316.23 |
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 $69.18 Median $77.62 Typical High $91.20 | Facility | 52 · Reduced service | $69.18 | $77.62 | $91.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.18 Median $30.90 Typical High $36.31 | Facility | 53 · Discontinued | $28.18 | $30.90 | $36.31 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $104.71 Median $114.82 Typical High $134.90 | Facility | 54 · Surgery only | $104.71 | $114.82 | $134.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.89 Median $22.91 Typical High $27.54 | Facility | 55 · Aftercare only | $20.89 | $22.91 | $27.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.49 Typical High $18.20 | Facility | 56 · Pre-op care only | $14.13 | $15.49 | $18.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $107.15 Typical High $125.89 | Facility | 78 · Unplanned return to OR | $97.72 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $75.86 Typical High $91.20 | Professional | 52 · Reduced service | $66.07 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $30.20 Typical High $36.31 | Professional | 53 · Discontinued | $26.30 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $114.82 Typical High $134.90 | Professional | 54 · Surgery only | $97.72 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $22.91 Typical High $27.54 | Professional | 55 · Aftercare only | $19.50 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $15.14 Typical High $18.20 | Professional | 56 · Pre-op care only | $13.18 | $15.14 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $107.15 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $91.20 | $107.15 | $125.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $257.04 Typical High $398.11 | Professional | 50 · Both sides | $208.93 | $257.04 | $398.11 |
Where California sits
The same service costs 4.6 times more in Alaska than in Florida. 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
$174
AK $617FL $135
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.