How much rates vary
Facilitymedian $871 · 10th to 90th $316 to $6,166Professionalmedian $245 · 10th to 90th $138 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 $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 $138.04 Median $245.47 Typical High $478.63 | Professional | None | $138.04 | $245.47 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
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 $147.91 Median $151.36 Typical High $758.58 | Professional | None | $147.91 | $151.36 | $758.58 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,174.90 Typical High $4,570.88 | Facility | None | $100.00 | $1,174.90 | $4,570.88 |
Blue Shield Setting Professional Modifier None Typical Low $117.49 Median $229.09 Typical High $363.08 | Professional | None | $117.49 | $229.09 | $363.08 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $407.38 | Professional | None | $147.91 | $245.47 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $398.11 Typical High $1,412.54 | Facility | None | $275.42 | $398.11 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $251.19 Typical High $457.09 | Professional | None | $141.25 | $251.19 | $457.09 |
Contra Costa Health Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $398.11 | Professional | None | $144.54 | $181.97 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $295.12 Typical High $562.34 | Professional | None | $141.25 | $295.12 | $562.34 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,398.83 | Professional | None | $2,290.87 | $2,290.87 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $389.05 | Professional | None | $229.09 | $229.09 | $389.05 |
Providence Setting Facility Modifier None Typical Low $245.47 Median $407.38 Typical High $2,570.40 | Facility | None | $245.47 | $407.38 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $141.25 Median $251.19 Typical High $446.68 | Professional | None | $141.25 | $251.19 | $446.68 |
Sutter Health Plus Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $933.25 | Professional | None | $512.86 | $512.86 | $933.25 |
United Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $4,466.84 | Facility | None | $549.54 | $549.54 | $4,466.84 |
United Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $489.78 | Professional | None | $128.82 | $239.88 | $489.78 |
14 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 $69.18 Median $74.13 Typical High $138.04 | Facility | 52 · Reduced service | $69.18 | $74.13 | $138.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $27.54 Median $29.51 Typical High $54.95 | Facility | 53 · Discontinued | $27.54 | $29.51 | $54.95 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $104.71 Median $112.20 Typical High $208.93 | Facility | 54 · Surgery only | $104.71 | $112.20 | $208.93 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.89 Median $22.39 Typical High $41.69 | Facility | 55 · Aftercare only | $20.89 | $22.39 | $41.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.79 Typical High $27.54 | Facility | 56 · Pre-op care only | $13.80 | $14.79 | $27.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $104.71 Typical High $194.98 | Facility | 78 · Unplanned return to OR | $97.72 | $104.71 | $194.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $109.65 Typical High $138.04 | Professional | 52 · Reduced service | $69.18 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $43.65 Typical High $54.95 | Professional | 53 · Discontinued | $27.54 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $162.18 Typical High $208.93 | Professional | 54 · Surgery only | $104.71 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $32.36 Typical High $41.69 | Professional | 55 · Aftercare only | $20.89 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $21.88 Typical High $27.54 | Professional | 56 · Pre-op care only | $13.80 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $151.36 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $97.72 | $151.36 | $194.98 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 59 · Distinct service | $281.84 | $281.84 | $281.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $309.03 Median $426.58 Typical High $524.81 | Professional | 50 · Both sides | $309.03 | $426.58 | $524.81 |
Where California sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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
$269
WY $741KY $195
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.