How much rates vary
Facilitymedian $1,259 · 10th to 90th $204 to $7,762Professionalmedian $309 · 10th to 90th $204 to $1,380
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 $213.80 Median $302.00 Typical High $436.52 | Professional | None | $213.80 | $302.00 | $436.52 |
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 $251.19 Median $354.81 Typical High $870.96 | Professional | None | $251.19 | $354.81 | $870.96 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,584.89 Typical High $6,309.57 | Facility | None | $100.00 | $1,584.89 | $6,309.57 |
Blue Shield Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $660.69 | Professional | None | $177.83 | $281.84 | $660.69 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $446.68 | Professional | None | $194.98 | $257.04 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $562.34 Typical High $1,778.28 | Facility | None | $398.11 | $562.34 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $562.34 | Professional | None | $218.78 | $309.03 | $562.34 |
Contra Costa Health Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $436.52 | Professional | None | $154.88 | $251.19 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $645.65 | Professional | None | $204.17 | $346.74 | $645.65 |
Lucent Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,630.27 | Professional | None | $2,137.96 | $2,137.96 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $407.38 | Professional | None | $245.47 | $245.47 | $407.38 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $575.44 Typical High $3,311.31 | Facility | None | $338.84 | $575.44 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $575.44 | Professional | None | $218.78 | $309.03 | $575.44 |
Sutter Health Plus Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,000.00 | Professional | None | $691.83 | $691.83 | $1,000.00 |
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 $177.83 Median $281.84 Typical High $724.44 | Professional | None | $177.83 | $281.84 | $724.44 |
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 $107.15 Median $125.89 Typical High $181.97 | Facility | 52 · Reduced service | $107.15 | $125.89 | $181.97 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $50.12 Typical High $72.44 | Facility | 53 · Discontinued | $42.66 | $50.12 | $72.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $186.21 Typical High $269.15 | Facility | 54 · Surgery only | $158.49 | $186.21 | $269.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $37.15 Typical High $54.95 | Facility | 55 · Aftercare only | $31.62 | $37.15 | $54.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.38 Median $25.12 Typical High $36.31 | Facility | 56 · Pre-op care only | $21.38 | $25.12 | $36.31 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $173.78 Typical High $251.19 | Facility | 78 · Unplanned return to OR | $147.91 | $173.78 | $251.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $131.83 Typical High $173.78 | Professional | 52 · Reduced service | $100.00 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $52.48 Typical High $70.79 | Professional | 53 · Discontinued | $39.81 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $199.53 Typical High $263.03 | Professional | 54 · Surgery only | $147.91 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $39.81 Typical High $52.48 | Professional | 55 · Aftercare only | $30.20 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $26.30 Typical High $35.48 | Professional | 56 · Pre-op care only | $19.95 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $186.21 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $138.04 | $186.21 | $245.47 |
Where California sits
The same service costs 3.7 times more in Wisconsin than in Utah. 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
$355
WI $891UT $240
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.