How much rates vary
Facilitymedian $1,660 · 10th to 90th $138 to $8,128Professionalmedian $200 · 10th to 90th $155 to $851
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 $173.78 Median $186.21 Typical High $208.93 | Professional | None | $173.78 | $186.21 | $208.93 |
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 $162.18 Median $181.97 Typical High $537.03 | Professional | None | $162.18 | $181.97 | $537.03 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,380.38 Typical High $6,165.95 | Facility | None | $100.00 | $1,380.38 | $6,165.95 |
Blue Shield Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $478.63 | Professional | None | $131.83 | $199.53 | $478.63 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $269.15 | Professional | None | $151.36 | $199.53 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $190.55 Typical High $2,691.53 | Facility | None | $120.23 | $190.55 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $380.19 | Professional | None | $165.96 | $194.98 | $380.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $251.19 | Professional | None | $147.91 | $186.21 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $457.09 | Professional | None | $151.36 | $208.93 | $457.09 |
Lucent Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,659.59 | $2,041.74 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $275.42 | Professional | None | $162.18 | $162.18 | $275.42 |
Providence Setting Facility Modifier None Typical Low $120.23 Median $208.93 Typical High $2,398.83 | Facility | None | $120.23 | $208.93 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $416.87 | Professional | None | $165.96 | $194.98 | $416.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $602.56 | Professional | None | $537.03 | $537.03 | $602.56 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,090.30 | $10,964.78 |
United Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $478.63 | Professional | None | $138.04 | $199.53 | $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 $87.10 Median $91.20 Typical High $104.71 | Facility | 52 · Reduced service | $87.10 | $91.20 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $34.67 Median $36.31 Typical High $41.69 | Facility | 53 · Discontinued | $34.67 | $36.31 | $41.69 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $128.82 Median $134.90 Typical High $154.88 | Facility | 54 · Surgery only | $128.82 | $134.90 | $154.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $27.54 Typical High $31.62 | Facility | 55 · Aftercare only | $25.70 | $27.54 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $18.20 Typical High $20.89 | Facility | 56 · Pre-op care only | $17.38 | $18.20 | $20.89 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $125.89 Typical High $144.54 | Facility | 78 · Unplanned return to OR | $120.23 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $83.18 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $33.11 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $134.90 Typical High $154.88 | Professional | 54 · Surgery only | $123.03 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $27.54 Typical High $31.62 | Professional | 55 · Aftercare only | $24.55 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.60 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $125.89 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $114.82 | $125.89 | $144.54 |
Where California sits
The same service costs 4.9 times more in Oklahoma than in Florida. 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· 42nd of 51
$209
OK $891FL $182
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.