How much rates vary
Facilitymedian $490 · 10th to 90th $105 to $6,166Professionalmedian $141 · 10th to 90th $107 to $347
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 $169.82 Median $5,011.87 Typical High $15,135.61 | Facility | None | $169.82 | $5,011.87 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $239.88 | Professional | None | $109.65 | $125.89 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $144.54 | Professional | None | $125.89 | $141.25 | $144.54 |
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 $134.90 Median $138.04 Typical High $363.08 | Professional | None | $134.90 | $138.04 | $363.08 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $426.58 Typical High $4,570.88 | Facility | None | $100.00 | $426.58 | $4,570.88 |
Blue Shield Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $186.21 | Professional | None | $91.20 | $134.90 | $186.21 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $204.17 | Professional | None | $104.71 | $154.88 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $138.04 Typical High $758.58 | Facility | None | $66.07 | $138.04 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $223.87 | Professional | None | $123.03 | $154.88 | $223.87 |
Contra Costa Health Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $199.53 | Professional | None | $104.71 | $125.89 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $323.59 | Professional | None | $107.15 | $165.96 | $323.59 |
Lucent Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,071.52 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $223.87 | Professional | None | $134.90 | $134.90 | $223.87 |
Providence Setting Facility Modifier None Typical Low $85.11 Median $144.54 Typical High $691.83 | Facility | None | $85.11 | $144.54 | $691.83 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $218.78 | Professional | None | $123.03 | $151.36 | $218.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $478.63 | Professional | None | $389.05 | $389.05 | $478.63 |
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 $100.00 Median $147.91 Typical High $239.88 | Professional | None | $100.00 | $147.91 | $239.88 |
11 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 $56.23 Median $61.66 Typical High $69.18 | Facility | 52 · Reduced service | $56.23 | $61.66 | $69.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.39 Median $24.55 Typical High $28.18 | Facility | 53 · Discontinued | $22.39 | $24.55 | $28.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.98 Median $18.20 Typical High $20.89 | Facility | 55 · Aftercare only | $16.98 | $18.20 | $20.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.30 Typical High $13.80 | Facility | 56 · Pre-op care only | $11.22 | $12.30 | $13.80 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $85.11 Typical High $97.72 | Facility | 78 · Unplanned return to OR | $77.62 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $61.66 Typical High $69.18 | Professional | 52 · Reduced service | $54.95 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $24.55 Typical High $28.18 | Professional | 53 · Discontinued | $21.88 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $91.20 Typical High $104.71 | Professional | 54 · Surgery only | $81.28 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $18.20 Typical High $20.89 | Professional | 55 · Aftercare only | $16.60 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.30 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.96 | $12.30 | $13.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $85.11 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $75.86 | $85.11 | $97.72 |
Where California sits
The same service costs 3.9 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· 45th of 51
$145
AK $501FL $129
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.