How much rates vary
Facilitymedian $1,148 · 10th to 90th $117 to $6,310Professionalmedian $204 · 10th to 90th $110 to $1,288
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 $109.65 Median $218.78 Typical High $426.58 | Professional | None | $109.65 | $218.78 | $426.58 |
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 $114.82 Median $138.04 Typical High $954.99 | Professional | None | $114.82 | $138.04 | $954.99 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,737.80 Typical High $5,011.87 | Facility | None | $100.00 | $1,737.80 | $5,011.87 |
Blue Shield Setting Professional Modifier None Typical Low $95.50 Median $177.83 Typical High $398.11 | Professional | None | $95.50 | $177.83 | $398.11 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $74.13 Median $141.25 Typical High $398.11 | Professional | None | $74.13 | $141.25 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $346.74 Typical High $707.95 | Facility | None | $53.70 | $346.74 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $489.78 | Professional | None | $117.49 | $208.93 | $489.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $66.07 Median $147.91 Typical High $389.05 | Professional | None | $66.07 | $147.91 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $288.40 Typical High $537.03 | Professional | None | $120.23 | $288.40 | $537.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,905.46 | $1,905.46 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $371.54 | Professional | None | $223.87 | $223.87 | $371.54 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $323.59 Typical High $707.95 | Facility | None | $61.66 | $323.59 | $707.95 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $204.17 Typical High $457.09 | Professional | None | $117.49 | $204.17 | $457.09 |
Sutter Health Plus Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $851.14 | Professional | None | $389.05 | $389.05 | $851.14 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,090.30 | Facility | None | $123.03 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $97.72 Median $208.93 Typical High $549.54 | Professional | None | $97.72 | $208.93 | $549.54 |
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 $54.95 Median $58.88 Typical High $123.03 | Facility | 52 · Reduced service | $54.95 | $58.88 | $123.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $23.99 Typical High $48.98 | Facility | 53 · Discontinued | $21.88 | $23.99 | $48.98 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $83.18 Median $89.13 Typical High $181.97 | Facility | 54 · Surgery only | $83.18 | $89.13 | $181.97 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.60 Median $17.78 Typical High $36.31 | Facility | 55 · Aftercare only | $16.60 | $17.78 | $36.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.02 Typical High $24.55 | Facility | 56 · Pre-op care only | $10.96 | $12.02 | $24.55 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $83.18 Typical High $169.82 | Facility | 78 · Unplanned return to OR | $77.62 | $83.18 | $169.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $93.33 Typical High $123.03 | Professional | 52 · Reduced service | $54.95 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $37.15 Typical High $48.98 | Professional | 53 · Discontinued | $21.88 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $141.25 Typical High $181.97 | Professional | 54 · Surgery only | $83.18 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $28.18 Typical High $36.31 | Professional | 55 · Aftercare only | $16.60 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $18.62 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.96 | $18.62 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $131.83 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $77.62 | $131.83 | $169.82 |
Where California sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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· 37th of 51
$219
AK $562KY $145
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.