How much rates vary
Facilitymedian $1,660 · 10th to 90th $501 to $6,918Professionalmedian $501 · 10th to 90th $347 to $2,692
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 $645.65 Median $5,888.44 Typical High $15,848.93 | Facility | None | $645.65 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $588.84 | Professional | None | $354.81 | $436.52 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $1,348.96 | Professional | None | $416.87 | $575.44 | $1,348.96 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,187.76 Typical High $6,918.31 | Facility | None | $100.00 | $2,187.76 | $6,918.31 |
Blue Shield Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $691.83 | Professional | None | $281.84 | $416.87 | $691.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $758.58 | Professional | None | $389.05 | $588.84 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,187.76 Typical High $3,801.89 | Facility | None | $575.44 | $2,187.76 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $812.83 | Professional | None | $354.81 | $489.78 | $812.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $741.31 | Professional | None | $389.05 | $467.74 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $588.84 Typical High $1,202.26 | Professional | None | $346.74 | $588.84 | $1,202.26 |
Lucent Health Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,570.88 | Professional | None | $3,801.89 | $3,801.89 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $741.31 | Professional | None | $446.68 | $446.68 | $741.31 |
Providence Setting Facility Modifier None Typical Low $501.19 Median $2,089.30 Typical High $4,265.80 | Facility | None | $501.19 | $2,089.30 | $4,265.80 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $794.33 | Professional | None | $354.81 | $478.63 | $794.33 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,202.26 | $1,698.24 |
United Setting Facility Modifier None Typical Low $501.19 Median $933.25 Typical High $3,548.13 | Facility | None | $501.19 | $933.25 | $3,548.13 |
United Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $912.01 | Professional | None | $288.40 | $446.68 | $912.01 |
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 $177.83 Median $204.17 Typical High $295.12 | Facility | 52 · Reduced service | $177.83 | $204.17 | $295.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $70.79 Median $81.28 Typical High $117.49 | Facility | 53 · Discontinued | $70.79 | $81.28 | $117.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $263.03 Median $309.03 Typical High $436.52 | Facility | 54 · Surgery only | $263.03 | $309.03 | $436.52 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $52.48 Median $61.66 Typical High $89.13 | Facility | 55 · Aftercare only | $52.48 | $61.66 | $89.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $35.48 Median $40.74 Typical High $58.88 | Facility | 56 · Pre-op care only | $35.48 | $40.74 | $58.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $288.40 Typical High $407.38 | Facility | 78 · Unplanned return to OR | $245.47 | $288.40 | $407.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $213.80 Typical High $269.15 | Professional | 52 · Reduced service | $177.83 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $87.10 Typical High $109.65 | Professional | 53 · Discontinued | $70.79 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $323.59 Typical High $407.38 | Professional | 54 · Surgery only | $263.03 | $323.59 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $64.57 Typical High $81.28 | Professional | 55 · Aftercare only | $52.48 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $43.65 Typical High $54.95 | Professional | 56 · Pre-op care only | $35.48 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $302.00 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $245.47 | $302.00 | $380.19 |
Where California sits
The same service costs 4.4 times more in Alaska 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· 37th of 51
$550
AK $1,950TX $447
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.