How much rates vary
Facilitymedian $3,090 · 10th to 90th $776 to $11,482Professionalmedian $427 · 10th to 90th $324 to $1,585
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 $8,128.31 Typical High $18,620.87 | Facility | None | $478.63 | $8,128.31 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $707.95 | Professional | None | $354.81 | $398.11 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $8,128.31 Typical High $16,982.44 | Facility | None | $3,890.45 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $1,548.82 | Professional | None | $398.11 | $446.68 | $1,548.82 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,548.82 Typical High $10,232.93 | Facility | None | $100.00 | $1,548.82 | $10,232.93 |
Blue Shield Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $977.24 | Professional | None | $275.42 | $389.05 | $977.24 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $234.42 Median $426.58 Typical High $562.34 | Professional | None | $234.42 | $426.58 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,691.53 Typical High $4,466.84 | Facility | None | $851.14 | $2,691.53 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $776.25 | Professional | None | $354.81 | $407.38 | $776.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $169.82 Median $416.87 Typical High $549.54 | Professional | None | $169.82 | $416.87 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $1,023.29 | Professional | None | $354.81 | $478.63 | $1,023.29 |
Lucent Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,801.89 | Professional | None | $3,019.95 | $3,019.95 | $3,801.89 |
Molina Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $630.96 | Professional | None | $380.19 | $380.19 | $630.96 |
Providence Setting Facility Modifier None Typical Low $512.86 Median $2,630.27 Typical High $5,888.44 | Facility | None | $512.86 | $2,630.27 | $5,888.44 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $891.25 | Professional | None | $331.13 | $398.11 | $891.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,174.90 | $1,174.90 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $11,220.18 | Facility | None | $1,258.93 | $3,090.30 | $11,220.18 |
United Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $1,047.13 | Professional | None | $302.00 | $426.58 | $1,047.13 |
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 $169.82 Median $177.83 Typical High $194.98 | Facility | 52 · Reduced service | $169.82 | $177.83 | $194.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $67.61 Median $72.44 Typical High $77.62 | Facility | 53 · Discontinued | $67.61 | $72.44 | $77.62 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $257.04 Median $269.15 Typical High $295.12 | Facility | 54 · Surgery only | $257.04 | $269.15 | $295.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $51.29 Median $53.70 Typical High $58.88 | Facility | 55 · Aftercare only | $51.29 | $53.70 | $58.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.88 Median $35.48 Typical High $38.90 | Facility | 56 · Pre-op care only | $33.88 | $35.48 | $38.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $251.19 Typical High $275.42 | Facility | 78 · Unplanned return to OR | $239.88 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $177.83 Typical High $194.98 | Professional | 52 · Reduced service | $162.18 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $72.44 Typical High $77.62 | Professional | 53 · Discontinued | $64.57 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $295.12 | Professional | 54 · Surgery only | $245.47 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $58.88 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $35.48 Typical High $38.90 | Professional | 56 · Pre-op care only | $32.36 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $275.42 |
Where California sits
The same service costs 4.3 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· 39th of 51
$457
AK $1,380UT $324
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.