How much rates vary
Facilitymedian $1,698 · 10th to 90th $501 to $7,244Professionalmedian $275 · 10th to 90th $209 to $575
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 $645.65 Median $5,888.44 Typical High $15,848.93 | Facility | None | $645.65 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $363.08 | Professional | None | $213.80 | $269.15 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $616.60 | Professional | None | $371.54 | $371.54 | $616.60 |
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 $208.93 Median $269.15 Typical High $389.05 | Professional | None | $208.93 | $269.15 | $389.05 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,698.24 Typical High $6,456.54 | Facility | None | $100.00 | $1,698.24 | $6,456.54 |
Blue Shield Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $380.19 | Professional | None | $186.21 | $263.03 | $380.19 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $426.58 | Professional | None | $194.98 | $263.03 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,071.52 Typical High $2,187.76 | Facility | None | $575.44 | $1,071.52 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $407.38 | Professional | None | $218.78 | $288.40 | $407.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $109.65 Median $257.04 Typical High $426.58 | Professional | None | $109.65 | $257.04 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $512.86 | Professional | None | $208.93 | $323.59 | $512.86 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,187.76 | $2,630.27 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $436.52 | Professional | None | $257.04 | $257.04 | $436.52 |
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 $389.05 Median $1,047.13 Typical High $4,365.16 | Facility | None | $389.05 | $1,047.13 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $380.19 | Professional | None | $218.78 | $288.40 | $380.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,000.00 | Professional | None | $741.31 | $741.31 | $1,000.00 |
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 $181.97 Median $269.15 Typical High $457.09 | Professional | None | $181.97 | $269.15 | $457.09 |
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 $107.15 Median $125.89 Typical High $169.82 | Facility | 52 · Reduced service | $107.15 | $125.89 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $43.65 Median $50.12 Typical High $69.18 | Facility | 53 · Discontinued | $43.65 | $50.12 | $69.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $162.18 Median $186.21 Typical High $257.04 | Facility | 54 · Surgery only | $162.18 | $186.21 | $257.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $32.36 Median $37.15 Typical High $51.29 | Facility | 55 · Aftercare only | $32.36 | $37.15 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.88 Median $25.12 Typical High $33.88 | Facility | 56 · Pre-op care only | $21.88 | $25.12 | $33.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $173.78 Typical High $239.88 | Facility | 78 · Unplanned return to OR | $151.36 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $128.82 Typical High $169.82 | Professional | 52 · Reduced service | $104.71 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $51.29 Typical High $69.18 | Professional | 53 · Discontinued | $41.69 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $190.55 Typical High $257.04 | Professional | 54 · Surgery only | $158.49 | $190.55 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $38.02 Typical High $51.29 | Professional | 55 · Aftercare only | $31.62 | $38.02 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $25.70 Typical High $33.88 | Professional | 56 · Pre-op care only | $20.89 | $25.70 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $177.83 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $147.91 | $177.83 | $239.88 |
Where California sits
The same service costs 4.3 times more in Alaska than in Utah. 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· 40th of 51
$275
AK $933UT $219
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.