How much rates vary
Facilitymedian $1,288 · 10th to 90th $331 to $6,918Professionalmedian $407 · 10th to 90th $234 to $977
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 $512.86 Median $5,754.40 Typical High $15,848.93 | Facility | None | $512.86 | $5,754.40 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $616.60 | Professional | None | $234.42 | $398.11 | $616.60 |
Ambetter Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $812.83 | Professional | None | $371.54 | $371.54 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $478.63 Typical High $1,047.13 | Professional | None | $257.04 | $478.63 | $1,047.13 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,819.70 Typical High $6,606.93 | Facility | None | $100.00 | $1,819.70 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $199.53 Median $389.05 Typical High $870.96 | Professional | None | $199.53 | $389.05 | $870.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $489.78 | Professional | None | $234.42 | $363.08 | $489.78 |
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 $229.09 Median $389.05 Typical High $707.95 | Professional | None | $229.09 | $389.05 | $707.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $489.78 | Professional | None | $257.04 | $316.23 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $389.05 Typical High $851.14 | Professional | None | $234.42 | $389.05 | $851.14 |
Lucent Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $549.54 | Professional | None | $331.13 | $331.13 | $549.54 |
Providence Setting Facility Modifier None Typical Low $446.68 Median $1,513.56 Typical High $4,265.80 | Facility | None | $446.68 | $1,513.56 | $4,265.80 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $707.95 | Professional | None | $229.09 | $389.05 | $707.95 |
Sutter Health Plus Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
Sutter Health Plus Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,202.26 | Professional | None | $741.31 | $741.31 | $1,202.26 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $4,073.80 | Facility | None | $331.13 | $501.19 | $4,073.80 |
United Setting Professional Modifier None Typical Low $190.55 Median $354.81 Typical High $831.76 | Professional | None | $190.55 | $354.81 | $831.76 |
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 $120.23 Median $131.83 Typical High $257.04 | Facility | 52 · Reduced service | $120.23 | $131.83 | $257.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $47.86 Median $52.48 Typical High $102.33 | Facility | 53 · Discontinued | $47.86 | $52.48 | $102.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $177.83 Median $194.98 Typical High $389.05 | Facility | 54 · Surgery only | $177.83 | $194.98 | $389.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $35.48 Median $38.90 Typical High $77.62 | Facility | 55 · Aftercare only | $35.48 | $38.90 | $77.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $23.99 Median $26.30 Typical High $51.29 | Facility | 56 · Pre-op care only | $23.99 | $26.30 | $51.29 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $181.97 Typical High $363.08 | Facility | 78 · Unplanned return to OR | $165.96 | $181.97 | $363.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $169.82 Typical High $223.87 | Professional | 52 · Reduced service | $117.49 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $67.61 Typical High $91.20 | Professional | 53 · Discontinued | $46.77 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $257.04 Typical High $338.84 | Professional | 54 · Surgery only | $173.78 | $257.04 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $51.29 Typical High $67.61 | Professional | 55 · Aftercare only | $34.67 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $33.88 Typical High $45.71 | Professional | 56 · Pre-op care only | $23.44 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $239.88 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $162.18 | $239.88 | $316.23 |
Where California sits
The same service costs 4.6 times more in Alaska 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· 23rd of 51
$457
AK $1,259UT $275
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.