How much rates vary
Facilitymedian $631 · 10th to 90th $95 to $6,310Professionalmedian $132 · 10th to 90th $95 to $501
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 $134.90 Median $7,079.46 Typical High $18,197.01 | Facility | None | $134.90 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $245.47 | Professional | None | $107.15 | $134.90 | $245.47 |
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 $100.00 Median $128.82 Typical High $398.11 | Professional | None | $100.00 | $128.82 | $398.11 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $1,479.11 | Facility | None | $97.72 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $269.15 | Professional | None | $70.79 | $114.82 | $269.15 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $67.61 Median $128.82 Typical High $208.93 | Professional | None | $67.61 | $128.82 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $676.08 | Facility | None | $50.12 | $61.66 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $263.03 | Professional | None | $100.00 | $134.90 | $263.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $60.26 Median $131.83 Typical High $208.93 | Professional | None | $60.26 | $131.83 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $331.13 | Professional | None | $107.15 | $165.96 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,047.13 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $204.17 | Professional | None | $120.23 | $120.23 | $204.17 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $134.90 Typical High $676.08 | Facility | None | $50.12 | $134.90 | $676.08 |
Providence Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $281.84 | Professional | None | $100.00 | $134.90 | $281.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $446.68 | Professional | None | $346.74 | $346.74 | $446.68 |
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 $87.10 Median $131.83 Typical High $338.84 | Professional | None | $87.10 | $131.83 | $338.84 |
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 $53.70 Median $58.88 Typical High $75.86 | Facility | 52 · Reduced service | $53.70 | $58.88 | $75.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.38 Median $23.44 Typical High $30.90 | Facility | 53 · Discontinued | $21.38 | $23.44 | $30.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $79.43 Median $89.13 Typical High $114.82 | Facility | 54 · Surgery only | $79.43 | $89.13 | $114.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $17.78 Typical High $22.91 | Facility | 55 · Aftercare only | $15.85 | $17.78 | $22.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.75 Typical High $15.14 | Facility | 56 · Pre-op care only | $10.72 | $11.75 | $15.14 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $83.18 Typical High $107.15 | Facility | 78 · Unplanned return to OR | $74.13 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $60.26 Typical High $75.86 | Professional | 52 · Reduced service | $53.70 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $23.99 Typical High $30.90 | Professional | 53 · Discontinued | $21.38 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $91.20 Typical High $114.82 | Professional | 54 · Surgery only | $79.43 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $18.20 Typical High $22.91 | Professional | 55 · Aftercare only | $15.85 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.02 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.72 | $12.02 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $85.11 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $74.13 | $85.11 | $107.15 |
Where California sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 44th of 51
$135
AK $437KY $105
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.