How much rates vary
Facilitymedian $1,259 · 10th to 90th $204 to $7,079Professionalmedian $331 · 10th to 90th $214 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 $204.17 Median $275.42 Typical High $380.19 | Professional | None | $204.17 | $275.42 | $380.19 |
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 $263.03 Median $363.08 Typical High $870.96 | Professional | None | $263.03 | $363.08 | $870.96 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,548.82 Typical High $4,897.79 | Facility | None | $100.00 | $1,548.82 | $4,897.79 |
Blue Shield Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $691.83 | Professional | None | $186.21 | $295.12 | $691.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $120.23 Median $245.47 Typical High $416.87 | Professional | None | $120.23 | $245.47 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $416.87 Typical High $1,862.09 | Facility | None | $257.04 | $416.87 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $575.44 | Professional | None | $229.09 | $316.23 | $575.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $93.33 Median $245.47 Typical High $407.38 | Professional | None | $93.33 | $245.47 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $660.69 | Professional | None | $199.53 | $323.59 | $660.69 |
Lucent Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,511.89 | Professional | None | $2,089.30 | $2,089.30 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $398.11 | Professional | None | $239.88 | $239.88 | $398.11 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $457.09 Typical High $4,365.16 | Facility | None | $251.19 | $457.09 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $575.44 | Professional | None | $229.09 | $316.23 | $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 $181.97 Median $295.12 Typical High $707.95 | Professional | None | $181.97 | $295.12 | $707.95 |
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 $109.65 Median $125.89 Typical High $186.21 | Facility | 52 · Reduced service | $109.65 | $125.89 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $43.65 Median $51.29 Typical High $75.86 | Facility | 53 · Discontinued | $43.65 | $51.29 | $75.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $162.18 Median $190.55 Typical High $281.84 | Facility | 54 · Surgery only | $162.18 | $190.55 | $281.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $32.36 Median $38.02 Typical High $56.23 | Facility | 55 · Aftercare only | $32.36 | $38.02 | $56.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.88 Median $25.12 Typical High $38.02 | Facility | 56 · Pre-op care only | $21.88 | $25.12 | $38.02 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $177.83 Typical High $263.03 | Facility | 78 · Unplanned return to OR | $151.36 | $177.83 | $263.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $138.04 Typical High $177.83 | Professional | 52 · Reduced service | $102.33 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $54.95 Typical High $70.79 | Professional | 53 · Discontinued | $40.74 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $208.93 Typical High $263.03 | Professional | 54 · Surgery only | $151.36 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $41.69 Typical High $52.48 | Professional | 55 · Aftercare only | $30.20 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $27.54 Typical High $35.48 | Professional | 56 · Pre-op care only | $20.42 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $194.98 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $141.25 | $194.98 | $245.47 |
Where California sits
The same service costs 3.7 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· 23rd of 51
$355
WI $891TX $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.