How much rates vary
Facilitymedian $813 · 10th to 90th $224 to $6,166Professionalmedian $158 · 10th to 90th $105 to $339
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 $107.15 Median $162.18 Typical High $229.09 | Professional | None | $107.15 | $162.18 | $229.09 |
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 $112.20 Median $162.18 Typical High $199.53 | Professional | None | $112.20 | $162.18 | $199.53 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,698.24 Typical High $6,606.93 | Facility | None | $100.00 | $1,698.24 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $186.21 | Professional | None | $89.13 | $125.89 | $186.21 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $275.42 | Professional | None | $87.10 | $134.90 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $295.12 Typical High $1,862.09 | Facility | None | $181.97 | $295.12 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $239.88 | Professional | None | $107.15 | $158.49 | $239.88 |
Contra Costa Health Setting Professional Modifier None Typical Low $60.26 Median $131.83 Typical High $269.15 | Professional | None | $60.26 | $131.83 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $316.23 | Professional | None | $104.71 | $194.98 | $316.23 |
Lucent Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,348.96 | $1,621.81 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $263.03 | Professional | None | $158.49 | $158.49 | $263.03 |
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 $165.96 Median $338.84 Typical High $3,801.89 | Facility | None | $165.96 | $338.84 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $234.42 | Professional | None | $107.15 | $154.88 | $234.42 |
Sutter Health Plus Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $588.84 | Professional | None | $354.81 | $354.81 | $588.84 |
United Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $3,548.13 | Facility | None | $501.19 | $812.83 | $3,548.13 |
United Setting Professional Modifier None Typical Low $89.13 Median $151.36 Typical High $263.03 | Professional | None | $89.13 | $151.36 | $263.03 |
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 $63.10 Typical High $100.00 | Facility | 52 · Reduced service | $53.70 | $63.10 | $100.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.38 Median $25.12 Typical High $39.81 | Facility | 53 · Discontinued | $21.38 | $25.12 | $39.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $81.28 Median $93.33 Typical High $147.91 | Facility | 54 · Surgery only | $81.28 | $93.33 | $147.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $18.62 Typical High $30.20 | Facility | 55 · Aftercare only | $16.22 | $18.62 | $30.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.59 Typical High $19.95 | Facility | 56 · Pre-op care only | $10.72 | $12.59 | $19.95 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $87.10 Typical High $138.04 | Facility | 78 · Unplanned return to OR | $75.86 | $87.10 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $72.44 Typical High $100.00 | Professional | 52 · Reduced service | $51.29 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $29.51 Typical High $39.81 | Professional | 53 · Discontinued | $20.42 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $109.65 Typical High $147.91 | Professional | 54 · Surgery only | $75.86 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.88 Typical High $30.20 | Professional | 55 · Aftercare only | $15.14 | $21.88 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.45 Typical High $19.95 | Professional | 56 · Pre-op care only | $10.23 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $102.33 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $70.79 | $102.33 | $138.04 |
Where California sits
The same service costs 3.4 times more in Alaska than in Florida. 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· 37th of 51
$158
AK $447FL $132
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.