How much rates vary
Facilitymedian $1,047 · 10th to 90th $151 to $6,166Professionalmedian $195 · 10th to 90th $115 to $550
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 $117.49 Median $194.98 Typical High $269.15 | Professional | None | $117.49 | $194.98 | $269.15 |
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 $125.89 Median $204.17 Typical High $245.47 | Professional | None | $125.89 | $204.17 | $245.47 |
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 $97.72 Median $147.91 Typical High $229.09 | Professional | None | $97.72 | $147.91 | $229.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $77.62 Median $154.88 Typical High $346.74 | Professional | None | $77.62 | $154.88 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $812.83 | Facility | None | $173.78 | $281.84 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $302.00 | Professional | None | $123.03 | $190.55 | $302.00 |
Contra Costa Health Setting Professional Modifier None Typical Low $53.70 Median $151.36 Typical High $338.84 | Professional | None | $53.70 | $151.36 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $239.88 Typical High $380.19 | Professional | None | $117.49 | $239.88 | $380.19 |
Lucent Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,621.81 | $1,995.26 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $316.23 | Professional | None | $186.21 | $186.21 | $316.23 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $331.13 Typical High $2,454.71 | Facility | None | $162.18 | $331.13 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $288.40 | Professional | None | $123.03 | $190.55 | $288.40 |
Sutter Health Plus Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $724.44 | Professional | None | $380.19 | $380.19 | $724.44 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $95.50 Median $186.21 Typical High $338.84 | Professional | None | $95.50 | $186.21 | $338.84 |
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 $63.10 Median $74.13 Typical High $134.90 | Facility | 52 · Reduced service | $63.10 | $74.13 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $29.51 Typical High $53.70 | Facility | 53 · Discontinued | $25.12 | $29.51 | $53.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $93.33 Median $112.20 Typical High $204.17 | Facility | 54 · Surgery only | $93.33 | $112.20 | $204.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $22.39 Typical High $40.74 | Facility | 55 · Aftercare only | $18.62 | $22.39 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.79 Typical High $26.92 | Facility | 56 · Pre-op care only | $12.59 | $14.79 | $26.92 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $104.71 Typical High $190.55 | Facility | 78 · Unplanned return to OR | $87.10 | $104.71 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $97.72 Typical High $134.90 | Professional | 52 · Reduced service | $58.88 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $38.90 Typical High $53.70 | Professional | 53 · Discontinued | $23.44 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $144.54 Typical High $204.17 | Professional | 54 · Surgery only | $87.10 | $144.54 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $28.84 Typical High $40.74 | Professional | 55 · Aftercare only | $17.38 | $28.84 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $19.50 Typical High $26.92 | Professional | 56 · Pre-op care only | $11.75 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $134.90 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $81.28 | $134.90 | $190.55 |
Where California sits
The same service costs 3.5 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· 32nd of 51
$195
AK $468TX $135
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.