How much rates vary
Facilitymedian $676 · 10th to 90th $126 to $6,166Professionalmedian $166 · 10th to 90th $117 to $380
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 $354.81 Median $5,128.61 Typical High $15,135.61 | Facility | None | $354.81 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $245.47 | Professional | None | $131.83 | $158.49 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $141.25 | Professional | None | $117.49 | $141.25 | $141.25 |
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 $141.25 Median $177.83 Typical High $371.54 | Professional | None | $141.25 | $177.83 | $371.54 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $724.44 Typical High $4,570.88 | Facility | None | $100.00 | $724.44 | $4,570.88 |
Blue Shield Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $229.09 | Professional | None | $104.71 | $151.36 | $229.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $194.98 | Professional | None | $117.49 | $144.54 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $186.21 Typical High $758.58 | Facility | None | $114.82 | $186.21 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $213.80 | Professional | None | $117.49 | $154.88 | $213.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $83.18 Median $141.25 Typical High $194.98 | Professional | None | $83.18 | $141.25 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $346.74 | Professional | None | $112.20 | $154.88 | $346.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,584.89 | $1,737.80 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $194.98 | Professional | None | $117.49 | $117.49 | $194.98 |
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 $123.03 Median $234.42 Typical High $2,570.40 | Facility | None | $123.03 | $234.42 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $208.93 | Professional | None | $117.49 | $147.91 | $208.93 |
Sutter Health Plus Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $436.52 | Professional | None | $380.19 | $380.19 | $436.52 |
United Setting Facility Modifier None Typical Low $123.03 Median $501.19 Typical High $3,090.30 | Facility | None | $123.03 | $501.19 | $3,090.30 |
United Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $229.09 | Professional | None | $93.33 | $134.90 | $229.09 |
14 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 $75.86 Typical High $87.10 | Facility | 52 · Reduced service | $69.18 | $75.86 | $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 $114.82 Typical High $128.82 | Facility | 54 · Surgery only | $104.71 | $114.82 | $128.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.89 Median $22.91 Typical High $25.70 | Facility | 55 · Aftercare only | $20.89 | $22.91 | $25.70 |
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 $107.15 Typical High $120.23 | Facility | 78 · Unplanned return to OR | $97.72 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $74.13 Typical High $79.43 | Professional | 52 · Reduced service | $66.07 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $29.51 Typical High $31.62 | Professional | 53 · Discontinued | $26.30 | $29.51 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $109.65 Typical High $117.49 | Professional | 54 · Surgery only | $100.00 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $21.88 Typical High $23.44 | Professional | 55 · Aftercare only | $19.95 | $21.88 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.79 Typical High $15.85 | Professional | 56 · Pre-op care only | $13.18 | $14.79 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $102.33 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $93.33 | $102.33 | $109.65 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $208.93 Typical High $281.84 | Professional | 50 · Both sides | $208.93 | $208.93 | $281.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $177.83 Median $218.78 Typical High $295.12 | Professional | 50 · Both sides | $177.83 | $218.78 | $295.12 |
Where California sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 30th of 51
$170
AK $490FL $117
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.