How much rates vary
Facilitymedian $1,349 · 10th to 90th $501 to $7,943Professionalmedian $234 · 10th to 90th $120 to $1,288
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 $645.65 Median $5,888.44 Typical High $15,848.93 | Facility | None | $645.65 | $5,888.44 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $208.93 Typical High $346.74 | Professional | None | $109.65 | $208.93 | $346.74 |
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 $125.89 Median $128.82 Typical High $724.44 | Professional | None | $125.89 | $128.82 | $724.44 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,174.90 Typical High $6,165.95 | Facility | None | $100.00 | $1,174.90 | $6,165.95 |
Blue Shield Setting Professional Modifier None Typical Low $102.33 Median $204.17 Typical High $354.81 | Professional | None | $102.33 | $204.17 | $354.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $162.18 Median $389.05 Typical High $537.03 | Professional | None | $162.18 | $389.05 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $891.25 Typical High $1,819.70 | Facility | None | $562.34 | $891.25 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $239.88 Typical High $446.68 | Professional | None | $123.03 | $239.88 | $446.68 |
Contra Costa Health Setting Professional Modifier None Typical Low $144.54 Median $309.03 Typical High $467.74 | Professional | None | $144.54 | $309.03 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $288.40 Typical High $537.03 | Professional | None | $125.89 | $288.40 | $537.03 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,290.87 | $2,951.21 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $371.54 | Professional | None | $223.87 | $223.87 | $371.54 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $870.96 Typical High $3,311.31 | Facility | None | $338.84 | $870.96 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $234.42 Typical High $426.58 | Professional | None | $123.03 | $234.42 | $426.58 |
Sutter Health Plus Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $891.25 | Professional | None | $446.68 | $446.68 | $891.25 |
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 $112.20 Median $229.09 Typical High $467.74 | Professional | None | $112.20 | $229.09 | $467.74 |
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 $60.26 Median $66.07 Typical High $134.90 | Facility | 52 · Reduced service | $60.26 | $66.07 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $26.30 Typical High $53.70 | Facility | 53 · Discontinued | $23.99 | $26.30 | $53.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $91.20 Median $97.72 Typical High $199.53 | Facility | 54 · Surgery only | $91.20 | $97.72 | $199.53 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.20 Median $19.50 Typical High $40.74 | Facility | 55 · Aftercare only | $18.20 | $19.50 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.18 Typical High $26.92 | Facility | 56 · Pre-op care only | $12.02 | $13.18 | $26.92 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $91.20 Typical High $186.21 | Facility | 78 · Unplanned return to OR | $85.11 | $91.20 | $186.21 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $104.71 Typical High $134.90 | Professional | 52 · Reduced service | $60.26 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $41.69 Typical High $53.70 | Professional | 53 · Discontinued | $23.99 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $158.49 Typical High $199.53 | Professional | 54 · Surgery only | $91.20 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $31.62 Typical High $40.74 | Professional | 55 · Aftercare only | $18.20 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $20.89 Typical High $26.92 | Professional | 56 · Pre-op care only | $12.02 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $147.91 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $85.11 | $147.91 | $186.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $354.81 Typical High $512.86 | Professional | 50 · Both sides | $269.15 | $354.81 | $512.86 |
Where California sits
The same service costs 4.7 times more in Alaska than in Virginia. 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· 31st of 51
$269
AK $851VA $182
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.