How much rates vary
Facilitymedian $2,188 · 10th to 90th $501 to $6,607Professionalmedian $468 · 10th to 90th $331 to $1,288
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 $5,128.61 Typical High $15,135.61 | Facility | None | $562.34 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $562.34 | Professional | None | $323.59 | $416.87 | $562.34 |
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 $354.81 Median $478.63 Typical High $616.60 | Professional | None | $354.81 | $478.63 | $616.60 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,621.81 Typical High $5,248.07 | Facility | None | $100.00 | $1,621.81 | $5,248.07 |
Blue Shield Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $602.56 | Professional | None | $288.40 | $416.87 | $602.56 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $776.25 | Professional | None | $416.87 | $562.34 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $2,187.76 Typical High $3,801.89 | Facility | None | $426.58 | $2,187.76 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $676.08 | Professional | None | $338.84 | $467.74 | $676.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $758.58 | Professional | None | $338.84 | $416.87 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $562.34 Typical High $891.25 | Professional | None | $331.13 | $562.34 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $3,890.45 Median $4,677.35 Typical High $4,677.35 | Professional | None | $3,890.45 | $4,677.35 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $776.25 | Professional | None | $457.09 | $457.09 | $776.25 |
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 $426.58 Median $1,995.26 Typical High $3,801.89 | Facility | None | $426.58 | $1,995.26 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $660.69 | Professional | None | $338.84 | $467.74 | $660.69 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,148.15 | $1,698.24 |
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 $281.84 Median $436.52 Typical High $758.58 | Professional | None | $281.84 | $436.52 | $758.58 |
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 $169.82 Median $194.98 Typical High $281.84 | Facility | 52 · Reduced service | $169.82 | $194.98 | $281.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $67.61 Median $79.43 Typical High $112.20 | Facility | 53 · Discontinued | $67.61 | $79.43 | $112.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $257.04 Median $295.12 Typical High $416.87 | Facility | 54 · Surgery only | $257.04 | $295.12 | $416.87 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $51.29 Median $58.88 Typical High $85.11 | Facility | 55 · Aftercare only | $51.29 | $58.88 | $85.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.90 Typical High $56.23 | Facility | 56 · Pre-op care only | $33.88 | $38.90 | $56.23 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $275.42 Typical High $389.05 | Facility | 78 · Unplanned return to OR | $239.88 | $275.42 | $389.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $208.93 Typical High $281.84 | Professional | 52 · Reduced service | $158.49 | $208.93 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $83.18 Typical High $112.20 | Professional | 53 · Discontinued | $64.57 | $83.18 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $309.03 Typical High $416.87 | Professional | 54 · Surgery only | $239.88 | $309.03 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $63.10 Typical High $85.11 | Professional | 55 · Aftercare only | $47.86 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $41.69 Typical High $56.23 | Professional | 56 · Pre-op care only | $32.36 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $288.40 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $223.87 | $288.40 | $389.05 |
Where California sits
The same service costs 3.7 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· 39th of 51
$479
AK $1,445NJ $389
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.