How much rates vary
Facilitymedian $1,122 · 10th to 90th $363 to $7,079Professionalmedian $309 · 10th to 90th $200 to $1,622
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 $741.31 Median $6,606.93 Typical High $15,848.93 | Facility | None | $741.31 | $6,606.93 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $389.05 | Professional | None | $213.80 | $269.15 | $389.05 |
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 $218.78 Median $239.88 Typical High $954.99 | Professional | None | $218.78 | $239.88 | $954.99 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,202.26 Typical High $5,011.87 | Facility | None | $100.00 | $1,202.26 | $5,011.87 |
Blue Shield Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $446.68 | Professional | None | $190.55 | $288.40 | $446.68 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $467.74 | Professional | None | $213.80 | $346.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $457.09 Typical High $1,412.54 | Facility | None | $323.59 | $457.09 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $537.03 | Professional | None | $199.53 | $302.00 | $537.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $457.09 | Professional | None | $213.80 | $269.15 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $338.84 Typical High $691.83 | Professional | None | $190.55 | $338.84 | $691.83 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,691.53 | $3,388.44 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $436.52 | Professional | None | $263.03 | $263.03 | $436.52 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $478.63 Typical High $3,388.44 | Facility | None | $309.03 | $478.63 | $3,388.44 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $489.78 | Professional | None | $199.53 | $302.00 | $489.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,023.29 | Professional | None | $645.65 | $645.65 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $7,585.78 | Facility | None | $1,071.52 | $1,071.52 | $7,585.78 |
United Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $549.54 | Professional | None | $162.18 | $281.84 | $549.54 |
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 $109.65 Median $120.23 Typical High $169.82 | Facility | 52 · Reduced service | $109.65 | $120.23 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $43.65 Median $47.86 Typical High $67.61 | Facility | 53 · Discontinued | $43.65 | $47.86 | $67.61 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $165.96 Median $177.83 Typical High $251.19 | Facility | 54 · Surgery only | $165.96 | $177.83 | $251.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.11 Median $35.48 Typical High $51.29 | Facility | 55 · Aftercare only | $33.11 | $35.48 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.88 Median $23.99 Typical High $33.88 | Facility | 56 · Pre-op care only | $21.88 | $23.99 | $33.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $165.96 Typical High $234.42 | Facility | 78 · Unplanned return to OR | $154.88 | $165.96 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $134.90 Typical High $169.82 | Professional | 52 · Reduced service | $104.71 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $53.70 Typical High $67.61 | Professional | 53 · Discontinued | $41.69 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $204.17 Typical High $251.19 | Professional | 54 · Surgery only | $154.88 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $40.74 Typical High $51.29 | Professional | 55 · Aftercare only | $30.90 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $26.92 Typical High $33.88 | Professional | 56 · Pre-op care only | $20.89 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $190.55 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $144.54 | $190.55 | $234.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $416.87 Typical High $602.56 | Professional | 50 · Both sides | $346.74 | $416.87 | $602.56 |
Where California sits
The same service costs 4.3 times more in Wyoming 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· 27th of 51
$339
WY $933UT $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.