How much rates vary
Facilitymedian $1,549 · 10th to 90th $355 to $7,943Professionalmedian $214 · 10th to 90th $148 to $617
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 $154.88 Median $218.78 Typical High $323.59 | Professional | None | $154.88 | $218.78 | $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 $151.36 Median $213.80 Typical High $295.12 | Professional | None | $151.36 | $213.80 | $295.12 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,698.24 Typical High $8,709.64 | Facility | None | $100.00 | $1,698.24 | $8,709.64 |
Blue Shield Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $229.09 | Professional | None | $112.20 | $162.18 | $229.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $138.04 Median $281.84 Typical High $478.63 | Professional | None | $138.04 | $281.84 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $489.78 Typical High $1,412.54 | Facility | None | $346.74 | $489.78 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $389.05 | Professional | None | $154.88 | $213.80 | $389.05 |
Contra Costa Health Setting Professional Modifier None Typical Low $95.50 Median $275.42 Typical High $467.74 | Professional | None | $95.50 | $275.42 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $562.34 | Professional | None | $204.17 | $346.74 | $562.34 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,187.76 | $2,754.23 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $416.87 | Professional | None | $251.19 | $251.19 | $416.87 |
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 $302.00 Median $501.19 Typical High $3,311.31 | Facility | None | $302.00 | $501.19 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $363.08 | Professional | None | $154.88 | $199.53 | $363.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,000.00 | Professional | None | $630.96 | $630.96 | $1,000.00 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $457.09 | Professional | None | $147.91 | $223.87 | $457.09 |
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 $83.18 Median $100.00 Typical High $144.54 | Facility | 52 · Reduced service | $83.18 | $100.00 | $144.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.11 Median $39.81 Typical High $58.88 | Facility | 53 · Discontinued | $33.11 | $39.81 | $58.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $125.89 Median $147.91 Typical High $218.78 | Facility | 54 · Surgery only | $125.89 | $147.91 | $218.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.12 Median $30.20 Typical High $43.65 | Facility | 55 · Aftercare only | $25.12 | $30.20 | $43.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.95 Typical High $28.84 | Facility | 56 · Pre-op care only | $16.60 | $19.95 | $28.84 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $138.04 Typical High $204.17 | Facility | 78 · Unplanned return to OR | $117.49 | $138.04 | $204.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $104.71 Typical High $144.54 | Professional | 52 · Reduced service | $79.43 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $41.69 Typical High $58.88 | Professional | 53 · Discontinued | $31.62 | $41.69 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $154.88 Typical High $218.78 | Professional | 54 · Surgery only | $120.23 | $154.88 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.90 Typical High $43.65 | Professional | 55 · Aftercare only | $23.99 | $30.90 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $20.89 Typical High $28.84 | Professional | 56 · Pre-op care only | $15.85 | $20.89 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $144.54 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $112.20 | $144.54 | $204.17 |
Where California sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 45th of 51
$219
AK $794KY $178
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.