How much rates vary
Facilitymedian $2,089 · 10th to 90th $603 to $7,413Professionalmedian $324 · 10th to 90th $251 to $776
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 $269.15 Median $354.81 Typical High $616.60 | Professional | None | $269.15 | $354.81 | $616.60 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $354.81 | Professional | None | $331.13 | $331.13 | $354.81 |
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 $251.19 Median $323.59 Typical High $467.74 | Professional | None | $251.19 | $323.59 | $467.74 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,187.76 Typical High $6,918.31 | Facility | None | $100.00 | $2,187.76 | $6,918.31 |
Blue Shield Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $426.58 | Professional | None | $218.78 | $309.03 | $426.58 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $524.81 | Professional | None | $331.13 | $331.13 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,187.76 Typical High $3,801.89 | Facility | None | $575.44 | $2,187.76 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $501.19 | Professional | None | $275.42 | $338.84 | $501.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $512.86 | Professional | None | $295.12 | $467.74 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $630.96 | Professional | None | $257.04 | $389.05 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,630.27 | $3,162.28 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $501.19 | Professional | None | $302.00 | $302.00 | $501.19 |
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 $446.68 Median $2,089.30 Typical High $4,265.80 | Facility | None | $446.68 | $2,089.30 | $4,265.80 |
Providence Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $467.74 | Professional | None | $275.42 | $338.84 | $467.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,202.26 | Professional | None | $891.25 | $891.25 | $1,202.26 |
United Setting Facility Modifier None Typical Low $691.83 Median $812.83 Typical High $4,570.88 | Facility | None | $691.83 | $812.83 | $4,570.88 |
United Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $549.54 | Professional | None | $218.78 | $316.23 | $549.54 |
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 $134.90 Median $158.49 Typical High $208.93 | Facility | 52 · Reduced service | $134.90 | $158.49 | $208.93 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $53.70 Median $63.10 Typical High $85.11 | Facility | 53 · Discontinued | $53.70 | $63.10 | $85.11 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $204.17 Median $239.88 Typical High $316.23 | Facility | 54 · Surgery only | $204.17 | $239.88 | $316.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $40.74 Median $47.86 Typical High $63.10 | Facility | 55 · Aftercare only | $40.74 | $47.86 | $63.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.92 Median $31.62 Typical High $41.69 | Facility | 56 · Pre-op care only | $26.92 | $31.62 | $41.69 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $223.87 Typical High $295.12 | Facility | 78 · Unplanned return to OR | $190.55 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $158.49 Typical High $208.93 | Professional | 52 · Reduced service | $125.89 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $63.10 Typical High $85.11 | Professional | 53 · Discontinued | $50.12 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $239.88 Typical High $316.23 | Professional | 54 · Surgery only | $190.55 | $239.88 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $47.86 Typical High $63.10 | Professional | 55 · Aftercare only | $38.02 | $47.86 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $31.62 Typical High $41.69 | Professional | 56 · Pre-op care only | $25.12 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $223.87 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $177.83 | $223.87 | $295.12 |
Where California sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 39th of 51
$331
AK $1,072NJ $263
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.