How much rates vary
Facilitymedian $4,169 · 10th to 90th $692 to $10,715Professionalmedian $427 · 10th to 90th $316 to $933
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 $741.31 Median $6,606.93 Typical High $15,848.93 | Facility | None | $741.31 | $6,606.93 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $741.31 | Professional | None | $331.13 | $426.58 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,511.38 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $588.84 | Professional | None | $346.74 | $426.58 | $588.84 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,238.72 Typical High $7,762.47 | Facility | None | $100.00 | $2,238.72 | $7,762.47 |
Blue Shield Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $524.81 | Professional | None | $275.42 | $389.05 | $524.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $630.96 | Professional | None | $416.87 | $457.09 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,466.84 Typical High $7,413.10 | Facility | None | $645.65 | $4,466.84 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $602.56 | Professional | None | $331.13 | $416.87 | $602.56 |
Contra Costa Health Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $630.96 | Professional | None | $281.84 | $416.87 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $758.58 | Professional | None | $323.59 | $478.63 | $758.58 |
Lucent Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,235.94 | $3,890.45 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $630.96 | Professional | None | $380.19 | $380.19 | $630.96 |
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 $524.81 Median $3,981.07 Typical High $7,413.10 | Facility | None | $524.81 | $3,981.07 | $7,413.10 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $562.34 | Professional | None | $331.13 | $416.87 | $562.34 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,445.44 | Professional | None | $1,122.02 | $1,122.02 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $11,220.18 | Facility | None | $1,258.93 | $3,090.30 | $11,220.18 |
United Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $676.08 | Professional | None | $269.15 | $389.05 | $676.08 |
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 $165.96 Median $194.98 Typical High $251.19 | Facility | 52 · Reduced service | $165.96 | $194.98 | $251.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $66.07 Median $77.62 Typical High $100.00 | Facility | 53 · Discontinued | $66.07 | $77.62 | $100.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $251.19 Median $288.40 Typical High $380.19 | Facility | 54 · Surgery only | $251.19 | $288.40 | $380.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $50.12 Median $57.54 Typical High $75.86 | Facility | 55 · Aftercare only | $50.12 | $57.54 | $75.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.90 Typical High $50.12 | Facility | 56 · Pre-op care only | $33.11 | $38.90 | $50.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $269.15 Typical High $354.81 | Facility | 78 · Unplanned return to OR | $234.42 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $194.98 Typical High $251.19 | Professional | 52 · Reduced service | $158.49 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $77.62 Typical High $100.00 | Professional | 53 · Discontinued | $63.10 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $288.40 Typical High $380.19 | Professional | 54 · Surgery only | $234.42 | $288.40 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $57.54 Typical High $75.86 | Professional | 55 · Aftercare only | $47.86 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $38.90 Typical High $50.12 | Professional | 56 · Pre-op care only | $31.62 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $269.15 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $218.78 | $269.15 | $354.81 |
Where California sits
The same service costs 6.7 times more in Alaska than in North Dakota. 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.
Physician feeFacility fee
AK $7,869ND $1,178
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.