How much rates vary
Facilitymedian $1,585 · 10th to 90th $234 to $7,244Professionalmedian $214 · 10th to 90th $138 to $550
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 $144.54 Median $218.78 Typical High $281.84 | Professional | None | $144.54 | $218.78 | $281.84 |
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 $138.04 Median $213.80 Typical High $288.40 | Professional | None | $138.04 | $213.80 | $288.40 |
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 $131.83 Median $194.98 Typical High $302.00 | Professional | None | $131.83 | $194.98 | $302.00 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $338.84 | Professional | None | $109.65 | $173.78 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $338.84 Typical High $1,412.54 | Facility | None | $223.87 | $338.84 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $316.23 | Professional | None | $151.36 | $229.09 | $316.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $75.86 Median $169.82 Typical High $331.13 | Professional | None | $75.86 | $169.82 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $389.05 | Professional | None | $134.90 | $239.88 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,621.81 | $1,995.26 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $316.23 | Professional | None | $190.55 | $190.55 | $316.23 |
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 $204.17 Median $346.74 Typical High $3,311.31 | Facility | None | $204.17 | $346.74 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $302.00 | Professional | None | $147.91 | $229.09 | $302.00 |
Sutter Health Plus Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $776.25 | Professional | None | $478.63 | $478.63 | $776.25 |
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 $117.49 Median $208.93 Typical High $354.81 | Professional | None | $117.49 | $208.93 | $354.81 |
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 $72.44 Median $85.11 Typical High $141.25 | Facility | 52 · Reduced service | $72.44 | $85.11 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.84 Median $33.88 Typical High $56.23 | Facility | 53 · Discontinued | $28.84 | $33.88 | $56.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $109.65 Median $128.82 Typical High $208.93 | Facility | 54 · Surgery only | $109.65 | $128.82 | $208.93 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.88 Median $25.70 Typical High $41.69 | Facility | 55 · Aftercare only | $21.88 | $25.70 | $41.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.98 Typical High $28.18 | Facility | 56 · Pre-op care only | $14.45 | $16.98 | $28.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $120.23 Typical High $194.98 | Facility | 78 · Unplanned return to OR | $102.33 | $120.23 | $194.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $102.33 Typical High $134.90 | Professional | 52 · Reduced service | $67.61 | $102.33 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $40.74 Typical High $54.95 | Professional | 53 · Discontinued | $27.54 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $154.88 Typical High $204.17 | Professional | 54 · Surgery only | $102.33 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $30.90 Typical High $40.74 | Professional | 55 · Aftercare only | $20.42 | $30.90 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $20.42 Typical High $27.54 | Professional | 56 · Pre-op care only | $13.80 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $144.54 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $95.50 | $144.54 | $190.55 |
Where California sits
The same service costs 3.5 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· 37th of 51
$214
AK $575NJ $166
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.