How much rates vary
Facilitymedian $1,288 · 10th to 90th $398 to $7,079Professionalmedian $288 · 10th to 90th $200 to $891
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 $199.53 Median $257.04 Typical High $346.74 | Professional | None | $199.53 | $257.04 | $346.74 |
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 $208.93 Median $295.12 Typical High $416.87 | Professional | None | $208.93 | $295.12 | $416.87 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,089.30 Typical High $6,606.93 | Facility | None | $100.00 | $2,089.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $363.08 | Professional | None | $181.97 | $263.03 | $363.08 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $537.03 | Professional | None | $257.04 | $323.59 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $549.54 Typical High $2,691.53 | Facility | None | $346.74 | $549.54 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $446.68 | Professional | None | $218.78 | $295.12 | $446.68 |
Contra Costa Health Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $537.03 | Professional | None | $199.53 | $257.04 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $380.19 Typical High $616.60 | Professional | None | $208.93 | $380.19 | $616.60 |
Lucent Health Setting Professional Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,511.89 | $3,311.31 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $489.78 | Professional | None | $295.12 | $295.12 | $489.78 |
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 $2,398.83 | Facility | None | $302.00 | $501.19 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $436.52 | Professional | None | $218.78 | $288.40 | $436.52 |
Sutter Health Plus Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,148.15 | Professional | None | $724.44 | $724.44 | $1,148.15 |
United Setting Facility Modifier None Typical Low $691.83 Median $812.83 Typical High $4,466.84 | Facility | None | $691.83 | $812.83 | $4,466.84 |
United Setting Professional Modifier None Typical Low $181.97 Median $281.84 Typical High $501.19 | Professional | None | $181.97 | $281.84 | $501.19 |
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 $100.00 Median $117.49 Typical High $173.78 | Facility | 52 · Reduced service | $100.00 | $117.49 | $173.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $40.74 Median $46.77 Typical High $69.18 | Facility | 53 · Discontinued | $40.74 | $46.77 | $69.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $151.36 Median $173.78 Typical High $257.04 | Facility | 54 · Surgery only | $151.36 | $173.78 | $257.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $34.67 Typical High $51.29 | Facility | 55 · Aftercare only | $30.20 | $34.67 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.95 Median $23.44 Typical High $34.67 | Facility | 56 · Pre-op care only | $19.95 | $23.44 | $34.67 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $162.18 Typical High $239.88 | Facility | 78 · Unplanned return to OR | $141.25 | $162.18 | $239.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $128.82 Typical High $173.78 | Professional | 52 · Reduced service | $100.00 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $51.29 Typical High $69.18 | Professional | 53 · Discontinued | $39.81 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $190.55 Typical High $257.04 | Professional | 54 · Surgery only | $147.91 | $190.55 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $38.02 Typical High $51.29 | Professional | 55 · Aftercare only | $29.51 | $38.02 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $25.70 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.95 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $177.83 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $138.04 | $177.83 | $239.88 |
Where California sits
The same service costs 3.6 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· 40th of 51
$295
AK $912NJ $251
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.