How much rates vary
Facilitymedian $427 · 10th to 90th $126 to $5,754Professionalmedian $174 · 10th to 90th $135 to $1,000
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 $128.82 Median $147.91 Typical High $173.78 | Professional | None | $128.82 | $147.91 | $173.78 |
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 $144.54 Median $147.91 Typical High $478.63 | Professional | None | $144.54 | $147.91 | $478.63 |
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 $123.03 Median $173.78 Typical High $234.42 | Professional | None | $123.03 | $173.78 | $234.42 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $389.05 | Professional | None | $154.88 | $288.40 | $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 $147.91 Median $173.78 Typical High $363.08 | Professional | None | $147.91 | $173.78 | $363.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $117.49 Median $281.84 Typical High $380.19 | Professional | None | $117.49 | $281.84 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $660.69 | Professional | None | $218.78 | $302.00 | $660.69 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,778.28 | $1,778.28 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $338.84 | Professional | None | $204.17 | $204.17 | $338.84 |
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 $223.87 Typical High $478.63 | Facility | None | $61.66 | $223.87 | $478.63 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $338.84 | Professional | None | $147.91 | $173.78 | $338.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | None | $630.96 | $630.96 | $758.58 |
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 $144.54 Median $190.55 Typical High $407.38 | Professional | None | $144.54 | $190.55 | $407.38 |
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 $67.61 Median $74.13 Typical High $87.10 | Facility | 52 · Reduced service | $67.61 | $74.13 | $87.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.92 Median $29.51 Typical High $34.67 | Facility | 53 · Discontinued | $26.92 | $29.51 | $34.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $102.33 Median $112.20 Typical High $128.82 | Facility | 54 · Surgery only | $102.33 | $112.20 | $128.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.42 Median $22.39 Typical High $25.70 | Facility | 55 · Aftercare only | $20.42 | $22.39 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.79 Typical High $17.38 | Facility | 56 · Pre-op care only | $13.49 | $14.79 | $17.38 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $104.71 Typical High $120.23 | Facility | 78 · Unplanned return to OR | $95.50 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $74.13 Typical High $87.10 | Professional | 52 · Reduced service | $63.10 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $29.51 Typical High $34.67 | Professional | 53 · Discontinued | $25.12 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $112.20 Typical High $128.82 | Professional | 54 · Surgery only | $95.50 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $22.39 Typical High $25.70 | Professional | 55 · Aftercare only | $19.05 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.79 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.59 | $14.79 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $104.71 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $89.13 | $104.71 | $120.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $263.03 Median $323.59 Typical High $537.03 | Professional | 50 · Both sides | $263.03 | $323.59 | $537.03 |
Where California sits
The same service costs 5.0 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· 49th of 51
$178
AK $832FL $166
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.