How much rates vary
Facilitymedian $468 · 10th to 90th $138 to $3,311Professionalmedian $120 · 10th to 90th $91 to $427
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 $91.20 Median $117.49 Typical High $218.78 | Professional | None | $91.20 | $117.49 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $123.03 | Professional | None | $89.13 | $117.49 | $123.03 |
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 $95.50 Median $97.72 Typical High $380.19 | Professional | None | $95.50 | $97.72 | $380.19 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $426.58 Typical High $1,412.54 | Facility | None | $100.00 | $426.58 | $1,412.54 |
Blue Shield Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $162.18 | Professional | None | $77.62 | $112.20 | $162.18 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $229.09 | Professional | None | $117.49 | $162.18 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $173.78 Typical High $758.58 | Facility | None | $109.65 | $173.78 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $204.17 | Professional | None | $91.20 | $120.23 | $204.17 |
Contra Costa Health Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $181.97 | Professional | None | $104.71 | $128.82 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $295.12 | Professional | None | $91.20 | $141.25 | $295.12 |
Lucent Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,122.02 | Professional | None | $933.25 | $933.25 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $181.97 | Professional | None | $107.15 | $107.15 | $181.97 |
Providence Setting Facility Modifier None Typical Low $112.20 Median $199.53 Typical High $2,570.40 | Facility | None | $112.20 | $199.53 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $199.53 | Professional | None | $91.20 | $120.23 | $199.53 |
Sutter Health Plus Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $426.58 | Professional | None | $338.84 | $338.84 | $426.58 |
United Setting Facility Modifier None Typical Low $331.13 Median $467.74 Typical High $1,071.52 | Facility | None | $331.13 | $467.74 | $1,071.52 |
United Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $223.87 | Professional | None | $83.18 | $112.20 | $223.87 |
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 $45.71 Median $48.98 Typical High $60.26 | Facility | 52 · Reduced service | $45.71 | $48.98 | $60.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $19.50 Typical High $24.55 | Facility | 53 · Discontinued | $18.20 | $19.50 | $24.55 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $67.61 Median $72.44 Typical High $91.20 | Facility | 54 · Surgery only | $67.61 | $72.44 | $91.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $14.45 Typical High $18.20 | Facility | 55 · Aftercare only | $13.49 | $14.45 | $18.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.77 Typical High $12.02 | Facility | 56 · Pre-op care only | $9.12 | $9.77 | $12.02 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $67.61 Typical High $85.11 | Facility | 78 · Unplanned return to OR | $63.10 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $48.98 Typical High $60.26 | Professional | 52 · Reduced service | $45.71 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.95 Typical High $24.55 | Professional | 53 · Discontinued | $18.20 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $74.13 Typical High $91.20 | Professional | 54 · Surgery only | $67.61 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $13.49 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.12 | $10.00 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $69.18 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $63.10 | $69.18 | $85.11 |
Where California sits
The same service costs 4.0 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· 36th of 51
$135
AK $407FL $102
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.