How much rates vary
Facilitymedian $2,692 · 10th to 90th $562 to $8,318Professionalmedian $224 · 10th to 90th $174 to $933
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 $5,888.44 Typical High $15,848.93 | Facility | None | $478.63 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $478.63 | Professional | None | $199.53 | $223.87 | $478.63 |
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 $190.55 Median $213.80 Typical High $602.56 | Professional | None | $190.55 | $213.80 | $602.56 |
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 $151.36 Median $223.87 Typical High $537.03 | Professional | None | $151.36 | $223.87 | $537.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $295.12 | Professional | None | $158.49 | $213.80 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,570.40 Typical High $4,466.84 | Facility | None | $575.44 | $2,570.40 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $416.87 | Professional | None | $181.97 | $218.78 | $416.87 |
Contra Costa Health Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $288.40 | Professional | None | $151.36 | $213.80 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $524.81 | Professional | None | $173.78 | $245.47 | $524.81 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,949.84 | $2,344.23 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $302.00 | Professional | None | $181.97 | $181.97 | $302.00 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $2,344.23 Typical High $4,677.35 | Facility | None | $288.40 | $2,344.23 | $4,677.35 |
Providence Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $457.09 | Professional | None | $181.97 | $218.78 | $457.09 |
Sutter Health Plus Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $676.08 | Professional | None | $602.56 | $602.56 | $676.08 |
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 $154.88 Median $223.87 Typical High $537.03 | Professional | None | $154.88 | $223.87 | $537.03 |
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 $107.15 Typical High $120.23 | Facility | 52 · Reduced service | $100.00 | $107.15 | $120.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $39.81 Median $42.66 Typical High $47.86 | Facility | 53 · Discontinued | $39.81 | $42.66 | $47.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $151.36 Median $158.49 Typical High $181.97 | Facility | 54 · Surgery only | $151.36 | $158.49 | $181.97 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $31.62 Typical High $36.31 | Facility | 55 · Aftercare only | $30.20 | $31.62 | $36.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.38 Typical High $23.99 | Facility | 56 · Pre-op care only | $19.95 | $21.38 | $23.99 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $147.91 Typical High $169.82 | Facility | 78 · Unplanned return to OR | $141.25 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $107.15 Typical High $120.23 | Professional | 52 · Reduced service | $95.50 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $42.66 Typical High $47.86 | Professional | 53 · Discontinued | $38.90 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $158.49 Typical High $181.97 | Professional | 54 · Surgery only | $144.54 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $31.62 Typical High $36.31 | Professional | 55 · Aftercare only | $28.84 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $19.05 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $147.91 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $134.90 | $147.91 | $169.82 |
Where California sits
The same service costs 5.9 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· 40th of 51
$245
OK $1,175UT $200
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.