How much rates vary
Facilitymedian $1,514 · 10th to 90th $148 to $6,607Professionalmedian $135 · 10th to 90th $98 to $282
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 $354.81 Median $5,128.61 Typical High $15,135.61 | Facility | None | $354.81 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $208.93 | Professional | None | $104.71 | $134.90 | $208.93 |
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 $97.72 Median $131.83 Typical High $190.55 | Professional | None | $97.72 | $131.83 | $190.55 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $1,584.89 Typical High $5,011.87 | Facility | None | $97.72 | $1,584.89 | $5,011.87 |
Blue Shield Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $177.83 | Professional | None | $87.10 | $123.03 | $177.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $213.80 | Professional | None | $85.11 | $138.04 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $213.80 Typical High $1,412.54 | Facility | None | $134.90 | $213.80 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $208.93 | Professional | None | $107.15 | $144.54 | $208.93 |
Contra Costa Health Setting Professional Modifier None Typical Low $58.88 Median $134.90 Typical High $208.93 | Professional | None | $58.88 | $134.90 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $257.04 | Professional | None | $107.15 | $158.49 | $257.04 |
Lucent Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,288.25 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $204.17 | Professional | None | $123.03 | $123.03 | $204.17 |
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 $134.90 Median $257.04 Typical High $2,454.71 | Facility | None | $134.90 | $257.04 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $190.55 | Professional | None | $107.15 | $144.54 | $190.55 |
Sutter Health Plus Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $489.78 | Professional | None | $354.81 | $354.81 | $489.78 |
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 $87.10 Median $131.83 Typical High $223.87 | Professional | None | $87.10 | $131.83 | $223.87 |
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 $52.48 Median $61.66 Typical High $87.10 | Facility | 52 · Reduced service | $52.48 | $61.66 | $87.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.38 Median $24.55 Typical High $34.67 | Facility | 53 · Discontinued | $21.38 | $24.55 | $34.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $79.43 Median $93.33 Typical High $131.83 | Facility | 54 · Surgery only | $79.43 | $93.33 | $131.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $18.62 Typical High $26.30 | Facility | 55 · Aftercare only | $15.85 | $18.62 | $26.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.30 Typical High $17.38 | Facility | 56 · Pre-op care only | $10.47 | $12.30 | $17.38 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $87.10 Typical High $123.03 | Facility | 78 · Unplanned return to OR | $74.13 | $87.10 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $64.57 Typical High $87.10 | Professional | 52 · Reduced service | $50.12 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $25.70 Typical High $34.67 | Professional | 53 · Discontinued | $19.95 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $95.50 Typical High $131.83 | Professional | 54 · Surgery only | $74.13 | $95.50 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.05 Typical High $26.30 | Professional | 55 · Aftercare only | $15.14 | $19.05 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.88 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.00 | $12.88 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $89.13 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $69.18 | $89.13 | $123.03 |
Where California sits
The same service costs 4.0 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· 42nd of 51
$135
AK $437NJ $110
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.