How much rates vary
Facilitymedian $1,862 · 10th to 90th $398 to $6,607Professionalmedian $174 · 10th to 90th $112 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 $112.20 Median $162.18 Typical High $239.88 | Professional | None | $112.20 | $162.18 | $239.88 |
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 $114.82 Median $117.49 Typical High $588.84 | Professional | None | $114.82 | $117.49 | $588.84 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $4,897.79 | Facility | None | $100.00 | $794.33 | $4,897.79 |
Blue Shield Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $239.88 | Professional | None | $95.50 | $151.36 | $239.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $288.40 | Professional | None | $123.03 | $154.88 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,862.09 Typical High $3,548.13 | Facility | None | $426.58 | $1,862.09 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $309.03 | Professional | None | $117.49 | $173.78 | $309.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $309.03 | Professional | None | $85.11 | $154.88 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $398.11 | Professional | None | $120.23 | $208.93 | $398.11 |
Lucent Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,412.54 | $1,412.54 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $269.15 | Professional | None | $162.18 | $162.18 | $269.15 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $1,698.24 Typical High $3,548.13 | Facility | None | $229.09 | $1,698.24 | $3,548.13 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $302.00 | Professional | None | $117.49 | $169.82 | $302.00 |
Sutter Health Plus Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $645.65 | Professional | None | $426.58 | $426.58 | $645.65 |
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 $104.71 Median $165.96 Typical High $331.13 | Professional | None | $104.71 | $165.96 | $331.13 |
13 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 $60.26 Typical High $91.20 | Facility | 52 · Reduced service | $56.23 | $60.26 | $91.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.39 Median $24.55 Typical High $36.31 | Facility | 53 · Discontinued | $22.39 | $24.55 | $36.31 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $83.18 Median $91.20 Typical High $134.90 | Facility | 54 · Surgery only | $83.18 | $91.20 | $134.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.60 Median $18.20 Typical High $26.92 | Facility | 55 · Aftercare only | $16.60 | $18.20 | $26.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.30 Typical High $18.20 | Facility | 56 · Pre-op care only | $11.22 | $12.30 | $18.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $85.11 Typical High $125.89 | Facility | 78 · Unplanned return to OR | $77.62 | $85.11 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $72.44 Typical High $91.20 | Professional | 52 · Reduced service | $56.23 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $28.84 Typical High $36.31 | Professional | 53 · Discontinued | $22.39 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $107.15 Typical High $134.90 | Professional | 54 · Surgery only | $83.18 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $21.38 Typical High $26.92 | Professional | 55 · Aftercare only | $16.60 | $21.38 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.45 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.22 | $14.45 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $100.00 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $77.62 | $100.00 | $125.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $234.42 Median $281.84 Typical High $346.74 | Professional | 50 · Both sides | $234.42 | $281.84 | $346.74 |
Where California sits
The same service costs 4.7 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· 38th of 51
$191
AK $708UT $151
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.