How much rates vary
Facilitymedian $1,445 · 10th to 90th $501 to $6,026Professionalmedian $191 · 10th to 90th $129 to $646
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 $131.83 Median $194.98 Typical High $309.03 | Professional | None | $131.83 | $194.98 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
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 $131.83 Median $190.55 Typical High $562.34 | Professional | None | $131.83 | $190.55 | $562.34 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,096.48 Typical High $5,011.87 | Facility | None | $100.00 | $1,096.48 | $5,011.87 |
Blue Shield Setting Professional Modifier None Typical Low $91.20 Median $173.78 Typical High $389.05 | Professional | None | $91.20 | $173.78 | $389.05 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $288.40 | Professional | None | $125.89 | $169.82 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,659.59 Typical High $3,467.37 | Facility | None | $426.58 | $1,659.59 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $363.08 | Professional | None | $125.89 | $190.55 | $363.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $281.84 | Professional | None | $120.23 | $158.49 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $416.87 | Professional | None | $131.83 | $223.87 | $416.87 |
Lucent Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $275.42 | Professional | None | $165.96 | $165.96 | $275.42 |
Providence Setting Facility Modifier None Typical Low $257.04 Median $1,584.89 Typical High $3,801.89 | Facility | None | $257.04 | $1,584.89 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $363.08 | Professional | None | $125.89 | $181.97 | $363.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $616.60 | Professional | None | $426.58 | $426.58 | $616.60 |
United Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $4,466.84 | Facility | None | $524.81 | $524.81 | $4,466.84 |
United Setting Professional Modifier None Typical Low $109.65 Median $186.21 Typical High $467.74 | Professional | None | $109.65 | $186.21 | $467.74 |
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 $67.61 Median $72.44 Typical High $109.65 | Facility | 52 · Reduced service | $67.61 | $72.44 | $109.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.92 Median $29.51 Typical High $43.65 | Facility | 53 · Discontinued | $26.92 | $29.51 | $43.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $100.00 Median $109.65 Typical High $162.18 | Facility | 54 · Surgery only | $100.00 | $109.65 | $162.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.95 Median $21.88 Typical High $33.11 | Facility | 55 · Aftercare only | $19.95 | $21.88 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.79 Typical High $21.88 | Facility | 56 · Pre-op care only | $13.49 | $14.79 | $21.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $102.33 Typical High $151.36 | Facility | 78 · Unplanned return to OR | $93.33 | $102.33 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $87.10 Typical High $109.65 | Professional | 52 · Reduced service | $66.07 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $34.67 Typical High $43.65 | Professional | 53 · Discontinued | $26.92 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $131.83 Typical High $162.18 | Professional | 54 · Surgery only | $100.00 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $26.30 Typical High $33.11 | Professional | 55 · Aftercare only | $19.95 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $17.38 Typical High $21.88 | Professional | 56 · Pre-op care only | $13.18 | $17.38 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $123.03 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $93.33 | $123.03 | $151.36 |
Where California sits
The same service costs 9.9 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $4,605MT $466
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.