How much rates vary
Facilitymedian $1,820 · 10th to 90th $631 to $7,762Professionalmedian $251 · 10th to 90th $191 to $891
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 $741.31 Median $6,606.93 Typical High $15,848.93 | Facility | None | $741.31 | $6,606.93 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $446.68 | Professional | None | $199.53 | $229.09 | $446.68 |
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 $239.88 Median $275.42 Typical High $741.31 | Professional | None | $239.88 | $275.42 | $741.31 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $7,244.36 | Facility | None | $100.00 | $2,137.96 | $7,244.36 |
Blue Shield Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $562.34 | Professional | None | $151.36 | $229.09 | $562.34 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $380.19 | Professional | None | $128.82 | $245.47 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $3,548.13 | Facility | None | $645.65 | $1,778.28 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $489.78 | Professional | None | $199.53 | $234.42 | $489.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $123.03 Median $239.88 Typical High $371.54 | Professional | None | $123.03 | $239.88 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $616.60 | Professional | None | $199.53 | $302.00 | $616.60 |
Lucent Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,344.23 | Professional | None | $2,041.74 | $2,041.74 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $398.11 | Professional | None | $234.42 | $234.42 | $398.11 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $1,698.24 Typical High $4,677.35 | Facility | None | $331.13 | $1,698.24 | $4,677.35 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $524.81 | Professional | None | $194.98 | $229.09 | $524.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $831.76 | Professional | None | $676.08 | $676.08 | $831.76 |
United Setting Facility Modifier None Typical Low $691.83 Median $758.58 Typical High $4,466.84 | Facility | None | $691.83 | $758.58 | $4,466.84 |
United Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $630.96 | Professional | None | $165.96 | $245.47 | $630.96 |
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 $100.00 Typical High $114.82 | Facility | 52 · Reduced service | $100.00 | $100.00 | $114.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $39.81 Median $40.74 Typical High $46.77 | Facility | 53 · Discontinued | $39.81 | $40.74 | $46.77 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $173.78 | Facility | 54 · Surgery only | $151.36 | $151.36 | $173.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $34.67 | Facility | 55 · Aftercare only | $30.20 | $30.20 | $34.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $23.44 | Facility | 56 · Pre-op care only | $19.95 | $19.95 | $23.44 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $141.25 Typical High $162.18 | Facility | 78 · Unplanned return to OR | $141.25 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $100.00 Typical High $114.82 | Professional | 52 · Reduced service | $100.00 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $40.74 Typical High $46.77 | Professional | 53 · Discontinued | $39.81 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $151.36 Typical High $173.78 | Professional | 54 · Surgery only | $147.91 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $30.20 Typical High $34.67 | Professional | 55 · Aftercare only | $29.51 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $20.42 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.95 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $141.25 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $138.04 | $141.25 | $162.18 |
Where California sits
The same service costs 4.7 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· 43rd of 51
$275
AK $1,000KY $214
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.