How much rates vary
Facilitymedian $1,072 · 10th to 90th $363 to $6,310Professionalmedian $224 · 10th to 90th $138 to $1,072
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 $134.90 Median $218.78 Typical High $281.84 | Professional | None | $134.90 | $218.78 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $147.91 Typical High $501.19 | Professional | None | $144.54 | $147.91 | $501.19 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $741.31 Typical High $4,570.88 | Facility | None | $100.00 | $741.31 | $4,570.88 |
Blue Shield Setting Professional Modifier None Typical Low $112.20 Median $208.93 Typical High $363.08 | Professional | None | $112.20 | $208.93 | $363.08 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $354.81 | Professional | None | $144.54 | $181.97 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $776.25 Typical High $1,659.59 | Facility | None | $436.52 | $776.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $380.19 | Professional | None | $141.25 | $234.42 | $380.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $346.74 | Professional | None | $107.15 | $173.78 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $263.03 Typical High $575.44 | Professional | None | $141.25 | $263.03 | $575.44 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,137.96 | Professional | None | $1,778.28 | $1,778.28 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $338.84 | Professional | None | $204.17 | $204.17 | $338.84 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $316.23 Median $758.58 Typical High $2,754.23 | Facility | None | $316.23 | $758.58 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $380.19 | Professional | None | $141.25 | $234.42 | $380.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $794.33 | Professional | None | $524.81 | $524.81 | $794.33 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,230.27 Typical High $4,677.35 | Facility | None | $398.11 | $1,230.27 | $4,677.35 |
United Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $407.38 | Professional | None | $128.82 | $213.80 | $407.38 |
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 $74.13 Typical High $141.25 | Facility | 52 · Reduced service | $69.18 | $74.13 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $27.54 Median $30.20 Typical High $57.54 | Facility | 53 · Discontinued | $27.54 | $30.20 | $57.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $102.33 Median $112.20 Typical High $213.80 | Facility | 54 · Surgery only | $102.33 | $112.20 | $213.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.42 Median $22.39 Typical High $42.66 | Facility | 55 · Aftercare only | $20.42 | $22.39 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.14 Typical High $28.18 | Facility | 56 · Pre-op care only | $13.80 | $15.14 | $28.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $104.71 Typical High $199.53 | Facility | 78 · Unplanned return to OR | $95.50 | $104.71 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $104.71 Typical High $125.89 | Professional | 52 · Reduced service | $66.07 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $26.30 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $158.49 Typical High $190.55 | Professional | 54 · Surgery only | $97.72 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $31.62 Typical High $38.02 | Professional | 55 · Aftercare only | $19.50 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $20.89 Typical High $25.12 | Professional | 56 · Pre-op care only | $13.18 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $147.91 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $91.20 | $147.91 | $177.83 |
Where California sits
The same service costs 4.2 times more in Alaska than in Virginia. 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· 36th of 51
$234
AK $776VA $186
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.