How much rates vary
Facilitymedian $1,288 · 10th to 90th $501 to $6,026Professionalmedian $182 · 10th to 90th $100 to $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 $107.15 Median $181.97 Typical High $302.00 | Professional | None | $107.15 | $181.97 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $323.59 | Professional | None | $186.21 | $186.21 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $2,137.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $223.87 | Professional | None | $100.00 | $181.97 | $223.87 |
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 $85.11 Median $144.54 Typical High $223.87 | Professional | None | $85.11 | $144.54 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,047.13 Typical High $1,778.28 | Facility | None | $426.58 | $1,047.13 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $288.40 | Professional | None | $107.15 | $173.78 | $288.40 |
Contra Costa Health Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $309.03 | Professional | None | $128.82 | $165.96 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $218.78 Typical High $346.74 | Professional | None | $107.15 | $218.78 | $346.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,513.56 | $1,819.70 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $295.12 | Professional | None | $177.83 | $177.83 | $295.12 |
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 $263.03 Median $1,023.29 Typical High $2,570.40 | Facility | None | $263.03 | $1,023.29 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $269.15 | Professional | None | $107.15 | $173.78 | $269.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $707.95 | Professional | None | $354.81 | $354.81 | $707.95 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $4,466.84 | Facility | None | $501.19 | $501.19 | $4,466.84 |
United Setting Professional Modifier None Typical Low $87.10 Median $173.78 Typical High $316.23 | Professional | None | $87.10 | $173.78 | $316.23 |
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 $53.70 Median $64.57 Typical High $125.89 | Facility | 52 · Reduced service | $53.70 | $64.57 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $25.70 Typical High $50.12 | Facility | 53 · Discontinued | $21.88 | $25.70 | $50.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $81.28 Median $95.50 Typical High $186.21 | Facility | 54 · Surgery only | $81.28 | $95.50 | $186.21 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $19.05 Typical High $37.15 | Facility | 55 · Aftercare only | $16.22 | $19.05 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.88 Typical High $25.12 | Facility | 56 · Pre-op care only | $10.72 | $12.88 | $25.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $89.13 Typical High $173.78 | Facility | 78 · Unplanned return to OR | $75.86 | $89.13 | $173.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $89.13 Typical High $125.89 | Professional | 52 · Reduced service | $50.12 | $89.13 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $35.48 Typical High $50.12 | Professional | 53 · Discontinued | $19.95 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $134.90 Typical High $186.21 | Professional | 54 · Surgery only | $75.86 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $26.92 Typical High $37.15 | Professional | 55 · Aftercare only | $15.14 | $26.92 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $17.78 Typical High $25.12 | Professional | 56 · Pre-op care only | $10.00 | $17.78 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $125.89 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $70.79 | $125.89 | $173.78 |
Where California sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 34th of 51
$182
AK $447DC $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.