How much rates vary
Facilitymedian $1,047 · 10th to 90th $288 to $7,244Professionalmedian $240 · 10th to 90th $162 to $479
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 $562.34 Median $5,888.44 Typical High $15,848.93 | Facility | None | $562.34 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $323.59 | Professional | None | $162.18 | $245.47 | $323.59 |
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 $177.83 Median $245.47 Typical High $323.59 | Professional | None | $177.83 | $245.47 | $323.59 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,698.24 Typical High $6,606.93 | Facility | None | $100.00 | $1,698.24 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $288.40 | Professional | None | $147.91 | $213.80 | $288.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $380.19 | Professional | None | $186.21 | $213.80 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $398.11 Typical High $1,862.09 | Facility | None | $245.47 | $398.11 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $346.74 | Professional | None | $173.78 | $239.88 | $346.74 |
Contra Costa Health Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $371.54 | Professional | None | $147.91 | $199.53 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $436.52 | Professional | None | $158.49 | $275.42 | $436.52 |
Lucent Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,819.70 | $2,238.72 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $346.74 | Professional | None | $208.93 | $208.93 | $346.74 |
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 $234.42 Median $436.52 Typical High $3,801.89 | Facility | None | $234.42 | $436.52 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $346.74 | Professional | None | $173.78 | $239.88 | $346.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $891.25 | Professional | None | $562.34 | $562.34 | $891.25 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $4,570.88 | Facility | None | $501.19 | $501.19 | $4,570.88 |
United Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $416.87 | Professional | None | $138.04 | $229.09 | $416.87 |
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 $87.10 Median $102.33 Typical High $158.49 | Facility | 52 · Reduced service | $87.10 | $102.33 | $158.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $34.67 Median $40.74 Typical High $63.10 | Facility | 53 · Discontinued | $34.67 | $40.74 | $63.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $128.82 Median $151.36 Typical High $234.42 | Facility | 54 · Surgery only | $128.82 | $151.36 | $234.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $30.20 Typical High $46.77 | Facility | 55 · Aftercare only | $25.70 | $30.20 | $46.77 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $20.42 Typical High $31.62 | Facility | 56 · Pre-op care only | $17.38 | $20.42 | $31.62 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $141.25 Typical High $218.78 | Facility | 78 · Unplanned return to OR | $120.23 | $141.25 | $218.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $114.82 Typical High $158.49 | Professional | 52 · Reduced service | $81.28 | $114.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $45.71 Typical High $63.10 | Professional | 53 · Discontinued | $32.36 | $45.71 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $173.78 Typical High $234.42 | Professional | 54 · Surgery only | $120.23 | $173.78 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $34.67 Typical High $46.77 | Professional | 55 · Aftercare only | $24.55 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.91 Typical High $31.62 | Professional | 56 · Pre-op care only | $16.22 | $22.91 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $162.18 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $112.20 | $162.18 | $218.78 |
Where California sits
The same service costs 3.6 times more in Alaska than in Texas. 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· 35th of 51
$245
AK $646TX $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.