How much rates vary
Facilitymedian $1,230 · 10th to 90th $355 to $6,166Professionalmedian $191 · 10th to 90th $112 to $617
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 $213.80 Median $7,079.46 Typical High $18,197.01 | Facility | None | $213.80 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $213.80 Typical High $436.52 | Professional | None | $117.49 | $213.80 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $457.09 | Professional | None | $346.74 | $346.74 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $186.21 Typical High $269.15 | Professional | None | $109.65 | $186.21 | $269.15 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $1,412.54 Typical High $4,786.30 | Facility | None | $97.72 | $1,412.54 | $4,786.30 |
Blue Shield Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $199.53 | Professional | None | $89.13 | $131.83 | $199.53 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $104.71 Median $275.42 Typical High $537.03 | Professional | None | $104.71 | $275.42 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $616.60 Typical High $1,778.28 | Facility | None | $398.11 | $616.60 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $346.74 | Professional | None | $114.82 | $186.21 | $346.74 |
Contra Costa Health Setting Professional Modifier None Typical Low $72.44 Median $269.15 Typical High $524.81 | Professional | None | $72.44 | $269.15 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $380.19 Typical High $602.56 | Professional | None | $204.17 | $380.19 | $602.56 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,238.72 | $3,090.30 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $426.58 | Professional | None | $257.04 | $257.04 | $426.58 |
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 $263.03 Median $549.54 Typical High $1,230.27 | Facility | None | $263.03 | $549.54 | $1,230.27 |
Providence Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $346.74 | Professional | None | $114.82 | $173.78 | $346.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,000.00 | Professional | None | $602.56 | $602.56 | $1,000.00 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,230.27 Typical High $4,677.35 | Facility | None | $398.11 | $1,230.27 | $4,677.35 |
United Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $478.63 | Professional | None | $128.82 | $213.80 | $478.63 |
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 $58.88 Median $67.61 Typical High $128.82 | Facility | 52 · Reduced service | $58.88 | $67.61 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $26.92 Typical High $51.29 | Facility | 53 · Discontinued | $23.44 | $26.92 | $51.29 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $87.10 Median $102.33 Typical High $190.55 | Facility | 54 · Surgery only | $87.10 | $102.33 | $190.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $20.42 Typical High $38.02 | Facility | 55 · Aftercare only | $17.78 | $20.42 | $38.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.49 Typical High $25.70 | Facility | 56 · Pre-op care only | $11.75 | $13.49 | $25.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $95.50 Typical High $177.83 | Facility | 78 · Unplanned return to OR | $81.28 | $95.50 | $177.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $93.33 Typical High $128.82 | Professional | 52 · Reduced service | $57.54 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $37.15 Typical High $51.29 | Professional | 53 · Discontinued | $22.91 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $138.04 Typical High $190.55 | Professional | 54 · Surgery only | $87.10 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $27.54 Typical High $38.02 | Professional | 55 · Aftercare only | $17.38 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $18.62 Typical High $25.70 | Professional | 56 · Pre-op care only | $11.48 | $18.62 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $128.82 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $81.28 | $128.82 | $177.83 |
Where California sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 49th of 51
$191
AK $741KY $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.