How much rates vary
Facilitymedian $912 · 10th to 90th $200 to $6,457Professionalmedian $112 · 10th to 90th $59 to $316
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 $60.26 Median $107.15 Typical High $316.23 | Professional | None | $60.26 | $107.15 | $316.23 |
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 $58.88 Median $109.65 Typical High $181.97 | Professional | None | $58.88 | $109.65 | $181.97 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $645.65 Typical High $4,570.88 | Facility | None | $100.00 | $645.65 | $4,570.88 |
Blue Shield Setting Professional Modifier None Typical Low $50.12 Median $97.72 Typical High $154.88 | Professional | None | $50.12 | $97.72 | $154.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $275.42 | Professional | None | $79.43 | $173.78 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $309.03 Typical High $1,862.09 | Facility | None | $194.98 | $309.03 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $123.03 Typical High $213.80 | Professional | None | $64.57 | $123.03 | $213.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $70.79 Median $120.23 Typical High $269.15 | Professional | None | $70.79 | $120.23 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $177.83 Typical High $295.12 | Professional | None | $63.10 | $177.83 | $295.12 |
Lucent Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,584.89 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $234.42 | Professional | None | $138.04 | $138.04 | $234.42 |
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 $158.49 Median $275.42 Typical High $1,862.09 | Facility | None | $158.49 | $275.42 | $1,862.09 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $123.03 Typical High $204.17 | Professional | None | $64.57 | $123.03 | $204.17 |
Sutter Health Plus Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $489.78 | Professional | None | $208.93 | $208.93 | $489.78 |
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 $51.29 Median $117.49 Typical High $245.47 | Professional | None | $51.29 | $117.49 | $245.47 |
11 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 $30.20 Median $34.67 Typical High $72.44 | Facility | 52 · Reduced service | $30.20 | $34.67 | $72.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.02 Median $13.80 Typical High $28.84 | Facility | 53 · Discontinued | $12.02 | $13.80 | $28.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $45.71 Median $51.29 Typical High $109.65 | Facility | 54 · Surgery only | $45.71 | $51.29 | $109.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.12 Median $10.47 Typical High $21.88 | Facility | 55 · Aftercare only | $9.12 | $10.47 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.92 Typical High $14.45 | Facility | 56 · Pre-op care only | $6.03 | $6.92 | $14.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $53.70 Typical High $72.44 | Professional | 52 · Reduced service | $29.51 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $21.38 Typical High $28.84 | Professional | 53 · Discontinued | $11.75 | $21.38 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $79.43 Typical High $109.65 | Professional | 54 · Surgery only | $44.67 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $15.85 Typical High $21.88 | Professional | 55 · Aftercare only | $8.91 | $15.85 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $10.72 Typical High $14.45 | Professional | 56 · Pre-op care only | $5.89 | $10.72 | $14.45 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 78 · Unplanned return to OR | $60.26 | $60.26 | $60.26 |
Where California sits
The same service costs 3.7 times more in Alaska than in Washington, DC. 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· 48th of 51
$115
AK $309DC $83.18
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.