How much rates vary
Facilitymedian $2,512 · 10th to 90th $537 to $10,233Professionalmedian $355 · 10th to 90th $245 to $1,023
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 $363.08 Median $7,079.46 Typical High $18,197.01 | Facility | None | $363.08 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $524.81 | Professional | None | $257.04 | $346.74 | $524.81 |
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 $263.03 Median $354.81 Typical High $467.74 | Professional | None | $263.03 | $354.81 | $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 $199.53 Median $281.84 Typical High $416.87 | Professional | None | $199.53 | $281.84 | $416.87 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $758.58 | Professional | None | $302.00 | $416.87 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $758.58 Typical High $2,691.53 | Facility | None | $537.03 | $758.58 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $575.44 | Professional | None | $257.04 | $346.74 | $575.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $173.78 Median $407.38 Typical High $741.31 | Professional | None | $173.78 | $407.38 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $549.54 Typical High $870.96 | Professional | None | $316.23 | $549.54 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $4,466.84 | Professional | None | $3,388.44 | $4,466.84 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $660.69 | Professional | None | $389.05 | $389.05 | $660.69 |
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 $416.87 Median $707.95 Typical High $2,398.83 | Facility | None | $416.87 | $707.95 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $524.81 | Professional | None | $257.04 | $346.74 | $524.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,513.56 | Professional | None | $977.24 | $977.24 | $1,513.56 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,495.41 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,495.41 | $17,378.01 |
United Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $676.08 | Professional | None | $229.09 | $363.08 | $676.08 |
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 $128.82 Median $151.36 Typical High $213.80 | Facility | 52 · Reduced service | $128.82 | $151.36 | $213.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $51.29 Median $60.26 Typical High $85.11 | Facility | 53 · Discontinued | $51.29 | $60.26 | $85.11 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $194.98 Median $223.87 Typical High $323.59 | Facility | 54 · Surgery only | $194.98 | $223.87 | $323.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.90 Median $44.67 Typical High $64.57 | Facility | 55 · Aftercare only | $38.90 | $44.67 | $64.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.70 Median $30.20 Typical High $42.66 | Facility | 56 · Pre-op care only | $25.70 | $30.20 | $42.66 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $208.93 Typical High $302.00 | Facility | 78 · Unplanned return to OR | $181.97 | $208.93 | $302.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $154.88 Typical High $213.80 | Professional | 52 · Reduced service | $123.03 | $154.88 | $213.80 |
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 $186.21 Median $234.42 Typical High $323.59 | Professional | 54 · Surgery only | $186.21 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $46.77 Typical High $64.57 | Professional | 55 · Aftercare only | $37.15 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $31.62 Typical High $42.66 | Professional | 56 · Pre-op care only | $25.12 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $218.78 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $173.78 | $218.78 | $302.00 |
Where California sits
The same service costs 4.3 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· 44th of 51
$355
AK $1,259KY $295
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.