How much rates vary
Facilitymedian $490 · 10th to 90th $324 to $5,888Professionalmedian $316 · 10th to 90th $245 to $1,096
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 $912.01 Median $6,025.60 Typical High $15,848.93 | Facility | None | $912.01 | $6,025.60 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $562.34 | Professional | None | $257.04 | $316.23 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $302.00 | Professional | None | $229.09 | $245.47 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $977.24 | Professional | None | $269.15 | $281.84 | $977.24 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $831.76 Typical High $6,025.60 | Facility | None | $100.00 | $831.76 | $6,025.60 |
Blue Shield Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $371.54 | Professional | None | $190.55 | $269.15 | $371.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $478.63 | Professional | None | $281.84 | $389.05 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $575.44 Typical High $1,148.15 | Facility | None | $407.38 | $575.44 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $537.03 | Professional | None | $275.42 | $316.23 | $537.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $186.21 Median $380.19 Typical High $467.74 | Professional | None | $186.21 | $380.19 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $831.76 | Professional | None | $288.40 | $389.05 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,884.03 | Professional | None | $2,398.83 | $2,398.83 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $467.74 | Professional | None | $275.42 | $275.42 | $467.74 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $575.44 Typical High $3,311.31 | Facility | None | $371.54 | $575.44 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $524.81 | Professional | None | $275.42 | $316.23 | $524.81 |
Sutter Health Plus Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,096.48 | Professional | None | $1,023.29 | $1,023.29 | $1,096.48 |
United Setting Facility Modifier None Typical Low $323.59 Median $398.11 Typical High $1,621.81 | Facility | None | $323.59 | $398.11 | $1,621.81 |
United Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $575.44 | Professional | None | $239.88 | $309.03 | $575.44 |
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 $125.89 Median $144.54 Typical High $158.49 | Facility | 52 · Reduced service | $125.89 | $144.54 | $158.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $63.10 | Facility | 53 · Discontinued | $51.29 | $57.54 | $63.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $190.55 Median $204.17 Typical High $234.42 | Facility | 54 · Surgery only | $190.55 | $204.17 | $234.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.02 Median $42.66 Typical High $46.77 | Facility | 55 · Aftercare only | $38.02 | $42.66 | $46.77 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.84 Typical High $31.62 | Facility | 56 · Pre-op care only | $25.70 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $144.54 Typical High $158.49 | Professional | 52 · Reduced service | $125.89 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $63.10 | Professional | 53 · Discontinued | $51.29 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $204.17 Typical High $234.42 | Professional | 54 · Surgery only | $190.55 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $42.66 Typical High $46.77 | Professional | 55 · Aftercare only | $38.02 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.84 Typical High $31.62 | Professional | 56 · Pre-op care only | $25.70 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $199.53 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $177.83 | $199.53 | $218.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $489.78 Typical High $645.65 | Professional | 50 · Both sides | $407.38 | $489.78 | $645.65 |
Where California sits
The same service costs 5.8 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· 40th of 51
$331
AK $1,259UT $219
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.