How much rates vary
Facilitymedian $1,122 · 10th to 90th $112 to $6,310Professionalmedian $170 · 10th to 90th $98 to $741
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 $97.72 Median $169.82 Typical High $323.59 | Professional | None | $97.72 | $169.82 | $323.59 |
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 $93.33 Median $123.03 Typical High $707.95 | Professional | None | $93.33 | $123.03 | $707.95 |
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 $85.11 Median $151.36 Typical High $338.84 | Professional | None | $85.11 | $151.36 | $338.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $61.66 Median $117.49 Typical High $275.42 | Professional | None | $61.66 | $117.49 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $208.93 Typical High $436.52 | Facility | None | $53.70 | $208.93 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $338.84 | Professional | None | $104.71 | $177.83 | $338.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $54.95 Median $138.04 Typical High $275.42 | Professional | None | $54.95 | $138.04 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $213.80 Typical High $380.19 | Professional | None | $112.20 | $213.80 | $380.19 |
Lucent Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,318.26 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $257.04 | Professional | None | $154.88 | $154.88 | $257.04 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $208.93 Typical High $758.58 | Facility | None | $61.66 | $208.93 | $758.58 |
Providence Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $338.84 | Professional | None | $104.71 | $177.83 | $338.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $602.56 | Professional | None | $346.74 | $346.74 | $602.56 |
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 $85.11 Median $158.49 Typical High $416.87 | Professional | None | $85.11 | $158.49 | $416.87 |
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 $48.98 Median $53.70 Typical High $95.50 | Facility | 52 · Reduced service | $48.98 | $53.70 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.50 Median $21.38 Typical High $38.90 | Facility | 53 · Discontinued | $19.50 | $21.38 | $38.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $74.13 Median $79.43 Typical High $144.54 | Facility | 54 · Surgery only | $74.13 | $79.43 | $144.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $15.85 Typical High $28.84 | Facility | 55 · Aftercare only | $14.79 | $15.85 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.72 Typical High $19.05 | Facility | 56 · Pre-op care only | $9.77 | $10.72 | $19.05 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $74.13 Typical High $134.90 | Facility | 78 · Unplanned return to OR | $69.18 | $74.13 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $74.13 Typical High $95.50 | Professional | 52 · Reduced service | $48.98 | $74.13 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $29.51 Typical High $38.90 | Professional | 53 · Discontinued | $19.50 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $112.20 Typical High $144.54 | Professional | 54 · Surgery only | $74.13 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $22.39 Typical High $28.84 | Professional | 55 · Aftercare only | $14.79 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $14.79 Typical High $19.05 | Professional | 56 · Pre-op care only | $9.77 | $14.79 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $104.71 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $69.18 | $104.71 | $134.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $138.04 Median $263.03 Typical High $630.96 | Professional | 50 · Both sides | $138.04 | $263.03 | $630.96 |
Where California sits
The same service costs 4.5 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· 38th of 51
$178
AK $457KY $102
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.