How much rates vary
Facilitymedian $1,047 · 10th to 90th $398 to $6,310Professionalmedian $912 · 10th to 90th $479 to $2,630
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 $1,000.00 Median $5,128.61 Typical High $15,135.61 | Facility | None | $1,000.00 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,047.13 | Professional | None | $588.84 | $870.96 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $512.86 Median $691.83 Typical High $2,089.30 | Professional | None | $512.86 | $691.83 | $2,089.30 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,023.29 Typical High $4,570.88 | Facility | None | $100.00 | $1,023.29 | $4,570.88 |
Blue Shield Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,348.96 | Professional | None | $707.95 | $977.24 | $1,348.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $1,122.02 | Professional | None | $549.54 | $758.58 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $537.03 Typical High $1,023.29 | Facility | None | $363.08 | $537.03 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $812.83 Typical High $1,230.27 | Professional | None | $478.63 | $812.83 | $1,230.27 |
Contra Costa Health Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $758.58 | Professional | None | $524.81 | $630.96 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $1,348.96 | Professional | None | $446.68 | $602.56 | $1,348.96 |
Lucent Health Setting Professional Modifier None Typical Low $4,786.30 Median $5,623.41 Typical High $5,623.41 | Professional | None | $4,786.30 | $5,623.41 | $5,623.41 |
Molina Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $741.31 | Professional | None | $446.68 | $446.68 | $741.31 |
Providence Setting Facility Modifier None Typical Low $398.11 Median $645.65 Typical High $2,570.40 | Facility | None | $398.11 | $645.65 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $467.74 Median $776.25 Typical High $1,148.15 | Professional | None | $467.74 | $776.25 | $1,148.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,737.80 | Professional | None | $1,621.81 | $1,621.81 | $1,737.80 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $4,677.35 | Facility | None | $398.11 | $1,202.26 | $4,677.35 |
United Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $1,148.15 | Professional | None | $398.11 | $575.44 | $1,148.15 |
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 $416.87 Median $457.09 Typical High $501.19 | Facility | 52 · Reduced service | $416.87 | $457.09 | $501.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $165.96 Median $186.21 Typical High $199.53 | Facility | 53 · Discontinued | $165.96 | $186.21 | $199.53 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $616.60 Median $691.83 Typical High $741.31 | Facility | 54 · Surgery only | $616.60 | $691.83 | $741.31 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $123.03 Median $138.04 Typical High $147.91 | Facility | 55 · Aftercare only | $123.03 | $138.04 | $147.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $83.18 Median $93.33 Typical High $100.00 | Facility | 56 · Pre-op care only | $83.18 | $93.33 | $100.00 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $645.65 Typical High $691.83 | Facility | 78 · Unplanned return to OR | $575.44 | $645.65 | $691.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $436.52 Typical High $467.74 | Professional | 52 · Reduced service | $398.11 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $186.21 | Professional | 53 · Discontinued | $158.49 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $660.69 Typical High $707.95 | Professional | 54 · Surgery only | $588.84 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $117.49 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $93.33 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $616.60 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $549.54 | $616.60 | $660.69 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $794.33 Typical High $1,737.80 | Professional | 50 · Both sides | $660.69 | $794.33 | $1,737.80 |
Where California sits
The same service costs 6.2 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· 12th of 51
$912
AK $1,995UT $324
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.