How much rates vary
Facilitymedian $871 · 10th to 90th $100 to $6,607Professionalmedian $209 · 10th to 90th $129 to $871
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 $208.93 Median $7,079.46 Typical High $18,197.01 | Facility | None | $208.93 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $257.04 | Professional | None | $128.82 | $181.97 | $257.04 |
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 $134.90 Median $213.80 Typical High $562.34 | Professional | None | $134.90 | $213.80 | $562.34 |
Blue Shield Setting Facility Modifier None Typical Low $89.13 Median $416.87 Typical High $1,584.89 | Facility | None | $89.13 | $416.87 | $1,584.89 |
Blue Shield Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $407.38 | Professional | None | $102.33 | $177.83 | $407.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $67.61 Median $131.83 Typical High $309.03 | Professional | None | $67.61 | $131.83 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $676.08 | Facility | None | $50.12 | $61.66 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $363.08 | Professional | None | $128.82 | $204.17 | $363.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $61.66 Median $158.49 Typical High $302.00 | Professional | None | $61.66 | $158.49 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $457.09 | Professional | None | $128.82 | $239.88 | $457.09 |
Lucent Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,412.54 | $1,412.54 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $263.03 | Professional | None | $158.49 | $158.49 | $263.03 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $165.96 Typical High $676.08 | Facility | None | $50.12 | $165.96 | $676.08 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $363.08 | Professional | None | $128.82 | $199.53 | $363.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $660.69 | Professional | None | $389.05 | $389.05 | $660.69 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $457.09 | Professional | None | $100.00 | $181.97 | $457.09 |
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 $64.57 Median $75.86 Typical High $125.89 | Facility | 52 · Reduced service | $64.57 | $75.86 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.70 Median $30.20 Typical High $51.29 | Facility | 53 · Discontinued | $25.70 | $30.20 | $51.29 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $95.50 Median $114.82 Typical High $190.55 | Facility | 54 · Surgery only | $95.50 | $114.82 | $190.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.05 Median $22.91 Typical High $38.02 | Facility | 55 · Aftercare only | $19.05 | $22.91 | $38.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.88 Median $15.14 Typical High $25.70 | Facility | 56 · Pre-op care only | $12.88 | $15.14 | $25.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $107.15 Typical High $177.83 | Facility | 78 · Unplanned return to OR | $89.13 | $107.15 | $177.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $91.20 Typical High $112.20 | Professional | 52 · Reduced service | $58.88 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $36.31 Typical High $44.67 | Professional | 53 · Discontinued | $23.99 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $134.90 Typical High $165.96 | Professional | 54 · Surgery only | $89.13 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $26.92 Typical High $33.88 | Professional | 55 · Aftercare only | $17.78 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $18.20 Typical High $22.39 | Professional | 56 · Pre-op care only | $11.75 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $125.89 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $83.18 | $125.89 | $154.88 |
Where California sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 31st of 51
$214
WI $589HI $155
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.