How much rates vary
Facilitymedian $955 · 10th to 90th $158 to $6,166Professionalmedian $148 · 10th to 90th $115 to $603
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 $117.49 Median $144.54 Typical High $199.53 | Professional | None | $117.49 | $144.54 | $199.53 |
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 $123.03 Median $134.90 Typical High $363.08 | Professional | None | $123.03 | $134.90 | $363.08 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,174.90 Typical High $4,677.35 | Facility | None | $100.00 | $1,174.90 | $4,677.35 |
Blue Shield Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $199.53 | Professional | None | $102.33 | $147.91 | $199.53 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $213.80 | Professional | None | $131.83 | $158.49 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $323.59 Typical High $1,348.96 | Facility | None | $204.17 | $323.59 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $245.47 | Professional | None | $128.82 | $154.88 | $245.47 |
Contra Costa Health Setting Professional Modifier None Typical Low $89.13 Median $158.49 Typical High $208.93 | Professional | None | $89.13 | $158.49 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $380.19 | Professional | None | $125.89 | $169.82 | $380.19 |
Lucent Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | None | $1,122.02 | $1,122.02 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $218.78 | Professional | None | $128.82 | $128.82 | $218.78 |
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 $186.21 Median $346.74 Typical High $2,570.40 | Facility | None | $186.21 | $346.74 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $229.09 | Professional | None | $128.82 | $147.91 | $229.09 |
Sutter Health Plus Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $512.86 | Professional | None | $426.58 | $426.58 | $512.86 |
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 $104.71 Median $141.25 Typical High $257.04 | Professional | None | $104.71 | $141.25 | $257.04 |
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 $61.66 Median $66.07 Typical High $77.62 | Facility | 52 · Reduced service | $61.66 | $66.07 | $77.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $24.55 Median $26.92 Typical High $30.90 | Facility | 53 · Discontinued | $24.55 | $26.92 | $30.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $93.33 Median $100.00 Typical High $117.49 | Facility | 54 · Surgery only | $93.33 | $100.00 | $117.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $19.95 Typical High $23.44 | Facility | 55 · Aftercare only | $18.62 | $19.95 | $23.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.18 Typical High $15.49 | Facility | 56 · Pre-op care only | $12.30 | $13.18 | $15.49 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $93.33 Typical High $109.65 | Facility | 78 · Unplanned return to OR | $87.10 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $66.07 Typical High $77.62 | Professional | 52 · Reduced service | $58.88 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.92 Typical High $30.90 | Professional | 53 · Discontinued | $23.44 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $100.00 Typical High $117.49 | Professional | 54 · Surgery only | $87.10 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.95 Typical High $23.44 | Professional | 55 · Aftercare only | $17.38 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.18 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.75 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $93.33 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $81.28 | $93.33 | $109.65 |
Where California sits
The same service costs 3.8 times more in Alaska than in Delaware. 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· 38th of 51
$151
AK $513DE $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.