How much rates vary
Facilitymedian $2,089 · 10th to 90th $562 to $8,318Professionalmedian $251 · 10th to 90th $186 to $1,000
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 $645.65 Median $5,888.44 Typical High $15,848.93 | Facility | None | $645.65 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $389.05 | Professional | None | $190.55 | $229.09 | $389.05 |
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 $208.93 Median $251.19 Typical High $691.83 | Professional | None | $208.93 | $251.19 | $691.83 |
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 $147.91 Median $239.88 Typical High $549.54 | Professional | None | $147.91 | $239.88 | $549.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $309.03 | Professional | None | $162.18 | $218.78 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,584.89 Typical High $3,090.30 | Facility | None | $575.44 | $1,584.89 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $446.68 | Professional | None | $186.21 | $234.42 | $446.68 |
Contra Costa Health Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $309.03 | Professional | None | $154.88 | $213.80 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $537.03 | Professional | None | $173.78 | $251.19 | $537.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,995.26 | $2,238.72 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $331.13 | Professional | None | $199.53 | $199.53 | $331.13 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $1,513.56 Typical High $4,265.80 | Facility | None | $302.00 | $1,513.56 | $4,265.80 |
Providence Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $478.63 | Professional | None | $186.21 | $229.09 | $478.63 |
Sutter Health Plus Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $741.31 | Professional | None | $616.60 | $616.60 | $741.31 |
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 $158.49 Median $239.88 Typical High $549.54 | Professional | None | $158.49 | $239.88 | $549.54 |
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 $100.00 Median $104.71 Typical High $128.82 | Facility | 52 · Reduced service | $100.00 | $104.71 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $39.81 Median $41.69 Typical High $51.29 | Facility | 53 · Discontinued | $39.81 | $41.69 | $51.29 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $151.36 Median $158.49 Typical High $190.55 | Facility | 54 · Surgery only | $151.36 | $158.49 | $190.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $31.62 Typical High $38.90 | Facility | 55 · Aftercare only | $30.20 | $31.62 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.95 Median $20.89 Typical High $25.70 | Facility | 56 · Pre-op care only | $19.95 | $20.89 | $25.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $147.91 Typical High $177.83 | Facility | 78 · Unplanned return to OR | $141.25 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $104.71 Typical High $128.82 | Professional | 52 · Reduced service | $95.50 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $42.66 Typical High $51.29 | Professional | 53 · Discontinued | $38.02 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $158.49 Typical High $190.55 | Professional | 54 · Surgery only | $141.25 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $31.62 Typical High $38.90 | Professional | 55 · Aftercare only | $28.18 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.89 Typical High $25.70 | Professional | 56 · Pre-op care only | $19.05 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $147.91 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $131.83 | $147.91 | $177.83 |
Where California sits
The same service costs 5.6 times more in Oklahoma than in Utah. 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· 38th of 51
$263
OK $1,148UT $204
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.