How much rates vary
Facilitymedian $417 · 10th to 90th $100 to $5,754Professionalmedian $110 · 10th to 90th $85 to $525
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 $89.13 Median $100.00 Typical High $120.23 | Professional | None | $89.13 | $100.00 | $120.23 |
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 $100.00 Median $102.33 Typical High $295.12 | Professional | None | $100.00 | $102.33 | $295.12 |
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 $75.86 Median $107.15 Typical High $151.36 | Professional | None | $75.86 | $107.15 | $151.36 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $281.84 | Professional | None | $128.82 | $177.83 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $134.90 Typical High $281.84 | Facility | None | $53.70 | $134.90 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $186.21 | Professional | None | $100.00 | $117.49 | $186.21 |
Contra Costa Health Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $190.55 | Professional | None | $128.82 | $158.49 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $309.03 | Professional | None | $109.65 | $144.54 | $309.03 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | None | $912.01 | $912.01 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $169.82 | Professional | None | $100.00 | $100.00 | $169.82 |
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 $58.88 Median $138.04 Typical High $309.03 | Facility | None | $58.88 | $138.04 | $309.03 |
Providence Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $186.21 | Professional | None | $100.00 | $114.82 | $186.21 |
Sutter Health Plus Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $389.05 | Professional | None | $331.13 | $331.13 | $389.05 |
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 $81.28 Median $102.33 Typical High $204.17 | Professional | None | $81.28 | $102.33 | $204.17 |
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 $46.77 Median $53.70 Typical High $58.88 | Facility | 52 · Reduced service | $46.77 | $53.70 | $58.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.62 Median $21.38 Typical High $23.99 | Facility | 53 · Discontinued | $18.62 | $21.38 | $23.99 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $70.79 Median $79.43 Typical High $89.13 | Facility | 54 · Surgery only | $70.79 | $79.43 | $89.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.13 Median $15.85 Typical High $17.78 | Facility | 55 · Aftercare only | $14.13 | $15.85 | $17.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.72 Typical High $12.02 | Facility | 56 · Pre-op care only | $9.33 | $10.72 | $12.02 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $74.13 Typical High $83.18 | Facility | 78 · Unplanned return to OR | $66.07 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $51.29 Typical High $58.88 | Professional | 52 · Reduced service | $44.67 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $20.42 Typical High $23.99 | Professional | 53 · Discontinued | $17.78 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $75.86 Typical High $89.13 | Professional | 54 · Surgery only | $67.61 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.14 Typical High $17.78 | Professional | 55 · Aftercare only | $13.49 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.91 | $10.00 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $70.79 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $63.10 | $70.79 | $83.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $165.96 Typical High $269.15 | Professional | 50 · Both sides | $131.83 | $165.96 | $269.15 |
Where California sits
The same service costs 4.5 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· 41st of 51
$112
AK $427FL $95.50
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.