How much rates vary
Facilitymedian $2,089 · 10th to 90th $398 to $12,303Professionalmedian $724 · 10th to 90th $437 to $1,820
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 $851.14 Median $6,606.93 Typical High $16,982.44 | Facility | None | $851.14 | $6,606.93 | $16,982.44 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $1,071.52 | Professional | None | $446.68 | $691.83 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,128.31 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $2,290.87 | Professional | None | $562.34 | $776.25 | $2,290.87 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,000.00 Typical High $12,022.64 | Facility | None | $100.00 | $1,000.00 | $12,022.64 |
Blue Shield Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $1,348.96 | Professional | None | $457.09 | $660.69 | $1,348.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $660.69 | Professional | None | $288.40 | $436.52 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $2,511.89 | Facility | None | $338.84 | $524.81 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $1,174.90 | Professional | None | $467.74 | $645.65 | $1,174.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $707.95 | Professional | None | $288.40 | $380.19 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $524.81 Typical High $1,096.48 | Professional | None | $302.00 | $524.81 | $1,096.48 |
Lucent Health Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $707.95 | Professional | None | $426.58 | $426.58 | $707.95 |
Providence Setting Facility Modifier None Typical Low $354.81 Median $630.96 Typical High $5,248.07 | Facility | None | $354.81 | $630.96 | $5,248.07 |
Providence Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $1,288.25 | Professional | None | $426.58 | $645.65 | $1,288.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,071.52 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $14,791.08 | Facility | None | $1,659.59 | $4,365.16 | $14,791.08 |
United Setting Professional Modifier None Typical Low $316.23 Median $562.34 Typical High $1,412.54 | Professional | None | $316.23 | $562.34 | $1,412.54 |
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 $269.15 Median $281.84 Typical High $426.58 | Facility | 52 · Reduced service | $269.15 | $281.84 | $426.58 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $109.65 Median $114.82 Typical High $169.82 | Facility | 53 · Discontinued | $109.65 | $114.82 | $169.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $407.38 Median $426.58 Typical High $630.96 | Facility | 54 · Surgery only | $407.38 | $426.58 | $630.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $81.28 Median $85.11 Typical High $125.89 | Facility | 55 · Aftercare only | $81.28 | $85.11 | $125.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $54.95 Median $57.54 Typical High $85.11 | Facility | 56 · Pre-op care only | $54.95 | $57.54 | $85.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $398.11 Typical High $588.84 | Facility | 78 · Unplanned return to OR | $380.19 | $398.11 | $588.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $281.84 Typical High $389.05 | Professional | 52 · Reduced service | $245.47 | $281.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $114.82 Typical High $158.49 | Professional | 53 · Discontinued | $97.72 | $114.82 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $426.58 Typical High $588.84 | Professional | 54 · Surgery only | $371.54 | $426.58 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $85.11 Typical High $117.49 | Professional | 55 · Aftercare only | $74.13 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $57.54 Typical High $77.62 | Professional | 56 · Pre-op care only | $48.98 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $398.11 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $346.74 | $398.11 | $549.54 |
Where California sits
The same service costs 4.3 times more in Wisconsin than in Texas. 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· 25th of 51
$741
WI $1,862TX $437
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.