How much rates vary
Facilitymedian $1,585 · 10th to 90th $427 to $6,607Professionalmedian $174 · 10th to 90th $129 to $933
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 $138.04 Median $154.88 Typical High $186.21 | Professional | None | $138.04 | $154.88 | $186.21 |
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 $128.82 Median $169.82 Typical High $660.69 | Professional | None | $128.82 | $169.82 | $660.69 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,584.89 Typical High $4,897.79 | Facility | None | $100.00 | $1,584.89 | $4,897.79 |
Blue Shield Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $407.38 | Professional | None | $112.20 | $158.49 | $407.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $75.86 Median $154.88 Typical High $263.03 | Professional | None | $75.86 | $154.88 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,047.13 Typical High $1,778.28 | Facility | None | $426.58 | $1,047.13 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $354.81 | Professional | None | $144.54 | $169.82 | $354.81 |
Contra Costa Health Setting Professional Modifier None Typical Low $67.61 Median $194.98 Typical High $263.03 | Professional | None | $67.61 | $194.98 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $457.09 | Professional | None | $158.49 | $218.78 | $457.09 |
Lucent Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,348.96 | $1,348.96 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $263.03 | Professional | None | $158.49 | $158.49 | $263.03 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $1,023.29 Typical High $2,570.40 | Facility | None | $223.87 | $1,023.29 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $380.19 | Professional | None | $144.54 | $165.96 | $380.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $575.44 | Professional | None | $501.19 | $501.19 | $575.44 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $457.09 | Professional | None | $123.03 | $173.78 | $457.09 |
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 $69.18 Median $77.62 Typical High $87.10 | Facility | 52 · Reduced service | $69.18 | $77.62 | $87.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $27.54 Median $30.90 Typical High $34.67 | Facility | 53 · Discontinued | $27.54 | $30.90 | $34.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $104.71 Median $117.49 Typical High $131.83 | Facility | 54 · Surgery only | $104.71 | $117.49 | $131.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.89 Median $23.44 Typical High $26.30 | Facility | 55 · Aftercare only | $20.89 | $23.44 | $26.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.49 Typical High $17.38 | Facility | 56 · Pre-op care only | $13.80 | $15.49 | $17.38 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $109.65 Typical High $123.03 | Facility | 78 · Unplanned return to OR | $97.72 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $77.62 Typical High $87.10 | Professional | 52 · Reduced service | $69.18 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $30.90 Typical High $34.67 | Professional | 53 · Discontinued | $27.54 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $117.49 Typical High $131.83 | Professional | 54 · Surgery only | $104.71 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $23.44 Typical High $26.30 | Professional | 55 · Aftercare only | $20.89 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.49 Typical High $17.38 | Professional | 56 · Pre-op care only | $13.80 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $109.65 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $97.72 | $109.65 | $123.03 |
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· 39th of 51
$204
AK $759UT $166
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.