How much rates vary
Facilitymedian $550 · 10th to 90th $166 to $5,623Professionalmedian $200 · 10th to 90th $120 to $490
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 $125.89 Median $218.78 Typical High $457.09 | Professional | None | $125.89 | $218.78 | $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 $120.23 Median $199.53 Typical High $257.04 | Professional | None | $120.23 | $199.53 | $257.04 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $426.58 Typical High $1,479.11 | Facility | None | $97.72 | $426.58 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $223.87 | Professional | None | $102.33 | $147.91 | $223.87 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $389.05 | Professional | None | $128.82 | $177.83 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $380.19 Typical High $794.33 | Facility | None | $269.15 | $380.19 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $309.03 | Professional | None | $128.82 | $199.53 | $309.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $91.20 Median $173.78 Typical High $389.05 | Professional | None | $91.20 | $173.78 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $275.42 Typical High $436.52 | Professional | None | $138.04 | $275.42 | $436.52 |
Lucent Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,737.80 | $2,344.23 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $338.84 | Professional | None | $199.53 | $199.53 | $338.84 |
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 $223.87 Median $398.11 Typical High $2,570.40 | Facility | None | $223.87 | $398.11 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $302.00 | Professional | None | $128.82 | $199.53 | $302.00 |
Sutter Health Plus Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $794.33 | Professional | None | $446.68 | $446.68 | $794.33 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,090.30 | Facility | None | $123.03 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $109.65 Median $194.98 Typical High $363.08 | Professional | None | $109.65 | $194.98 | $363.08 |
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 $63.10 Median $72.44 Typical High $131.83 | Facility | 52 · Reduced service | $63.10 | $72.44 | $131.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.70 Median $29.51 Typical High $53.70 | Facility | 53 · Discontinued | $25.70 | $29.51 | $53.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $95.50 Median $109.65 Typical High $199.53 | Facility | 54 · Surgery only | $95.50 | $109.65 | $199.53 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.05 Median $21.88 Typical High $39.81 | Facility | 55 · Aftercare only | $19.05 | $21.88 | $39.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.45 Typical High $26.30 | Facility | 56 · Pre-op care only | $12.59 | $14.45 | $26.30 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $102.33 Typical High $186.21 | Facility | 78 · Unplanned return to OR | $89.13 | $102.33 | $186.21 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $97.72 Typical High $131.83 | Professional | 52 · Reduced service | $61.66 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $38.90 Typical High $53.70 | Professional | 53 · Discontinued | $24.55 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $144.54 Typical High $199.53 | Professional | 54 · Surgery only | $91.20 | $144.54 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $29.51 Typical High $39.81 | Professional | 55 · Aftercare only | $18.20 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $19.50 Typical High $26.30 | Professional | 56 · Pre-op care only | $12.30 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $134.90 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $85.11 | $134.90 | $186.21 |
Where California sits
The same service costs 3.5 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· 40th of 51
$200
AK $562DC $162
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.