How much rates vary
Facilitymedian $1,230 · 10th to 90th $204 to $6,166Professionalmedian $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 $478.63 Median $5,128.61 Typical High $15,135.61 | Facility | None | $478.63 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $380.19 | Professional | None | $199.53 | $288.40 | $380.19 |
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 $257.04 Median $363.08 Typical High $933.25 | Professional | None | $257.04 | $363.08 | $933.25 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,584.89 Typical High $4,897.79 | Facility | None | $100.00 | $1,584.89 | $4,897.79 |
Blue Shield Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $707.95 | Professional | None | $186.21 | $295.12 | $707.95 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $457.09 | Professional | None | $194.98 | $263.03 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $524.81 Typical High $1,412.54 | Facility | None | $354.81 | $524.81 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $602.56 | Professional | None | $229.09 | $331.13 | $602.56 |
Contra Costa Health Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $446.68 | Professional | None | $151.36 | $257.04 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $354.81 Typical High $776.25 | Professional | None | $208.93 | $354.81 | $776.25 |
Lucent Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,691.53 | Professional | None | $2,137.96 | $2,137.96 | $2,691.53 |
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 $331.13 Median $549.54 Typical High $2,454.71 | Facility | None | $331.13 | $549.54 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $616.60 | Professional | None | $218.78 | $323.59 | $616.60 |
Sutter Health Plus Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,174.90 | Professional | None | $758.58 | $758.58 | $1,174.90 |
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 $190.55 Median $309.03 Typical High $794.33 | Professional | None | $190.55 | $309.03 | $794.33 |
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 $190.55 | Facility | 52 · Reduced service | $107.15 | $125.89 | $190.55 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $50.12 Typical High $75.86 | Facility | 53 · Discontinued | $42.66 | $50.12 | $75.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $162.18 Median $190.55 Typical High $288.40 | Facility | 54 · Surgery only | $162.18 | $190.55 | $288.40 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $32.36 Median $38.02 Typical High $57.54 | Facility | 55 · Aftercare only | $32.36 | $38.02 | $57.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.38 Median $25.12 Typical High $38.02 | Facility | 56 · Pre-op care only | $21.38 | $25.12 | $38.02 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $177.83 Typical High $269.15 | Facility | 78 · Unplanned return to OR | $151.36 | $177.83 | $269.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $141.25 Typical High $190.55 | Professional | 52 · Reduced service | $102.33 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $56.23 Typical High $75.86 | Professional | 53 · Discontinued | $40.74 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $208.93 Typical High $281.84 | Professional | 54 · Surgery only | $151.36 | $208.93 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $41.69 Typical High $57.54 | Professional | 55 · Aftercare only | $30.20 | $41.69 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $28.18 Typical High $38.02 | Professional | 56 · Pre-op care only | $20.42 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $194.98 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $141.25 | $194.98 | $269.15 |
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· 27th of 51
$363
WI $933TX $251
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.