How much rates vary
Facilitymedian $1,622 · 10th to 90th $427 to $6,607Professionalmedian $191 · 10th to 90th $138 to $437
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 $147.91 Median $204.17 Typical High $257.04 | Professional | None | $147.91 | $204.17 | $257.04 |
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 $186.21 Typical High $269.15 | Professional | None | $138.04 | $186.21 | $269.15 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,584.89 Typical High $5,011.87 | Facility | None | $100.00 | $1,584.89 | $5,011.87 |
Blue Shield Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $251.19 | Professional | None | $120.23 | $173.78 | $251.19 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $309.03 | Professional | None | $107.15 | $190.55 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,047.13 Typical High $1,778.28 | Facility | None | $426.58 | $1,047.13 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $288.40 | Professional | None | $147.91 | $199.53 | $288.40 |
Contra Costa Health Setting Professional Modifier None Typical Low $74.13 Median $186.21 Typical High $302.00 | Professional | None | $74.13 | $186.21 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $363.08 | Professional | None | $147.91 | $223.87 | $363.08 |
Lucent Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,548.82 | $1,862.09 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $302.00 | Professional | None | $181.97 | $181.97 | $302.00 |
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 $269.15 Median $1,023.29 Typical High $2,570.40 | Facility | None | $269.15 | $1,023.29 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $269.15 | Professional | None | $147.91 | $199.53 | $269.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $707.95 | Professional | None | $501.19 | $501.19 | $707.95 |
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 $123.03 Median $186.21 Typical High $323.59 | Professional | None | $123.03 | $186.21 | $323.59 |
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 $74.13 Median $87.10 Typical High $123.03 | Facility | 52 · Reduced service | $74.13 | $87.10 | $123.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $29.51 Median $34.67 Typical High $48.98 | Facility | 53 · Discontinued | $29.51 | $34.67 | $48.98 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $112.20 Median $128.82 Typical High $181.97 | Facility | 54 · Surgery only | $112.20 | $128.82 | $181.97 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.39 Median $25.70 Typical High $36.31 | Facility | 55 · Aftercare only | $22.39 | $25.70 | $36.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.79 Median $17.38 Typical High $24.55 | Facility | 56 · Pre-op care only | $14.79 | $17.38 | $24.55 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $120.23 Typical High $169.82 | Facility | 78 · Unplanned return to OR | $104.71 | $120.23 | $169.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $89.13 Typical High $123.03 | Professional | 52 · Reduced service | $69.18 | $89.13 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $36.31 Typical High $48.98 | Professional | 53 · Discontinued | $28.18 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $134.90 Typical High $181.97 | Professional | 54 · Surgery only | $104.71 | $134.90 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $26.92 Typical High $36.31 | Professional | 55 · Aftercare only | $20.89 | $26.92 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.20 Typical High $24.55 | Professional | 56 · Pre-op care only | $14.13 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $125.89 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $97.72 | $125.89 | $169.82 |
Where California sits
The same service costs 4.2 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· 41st of 51
$191
AK $646NJ $155
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.