How much rates vary
Facilitymedian $1,023 · 10th to 90th $550 to $6,761Professionalmedian $380 · 10th to 90th $240 to $2,344
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 $239.88 Median $323.59 Typical High $512.86 | Professional | None | $239.88 | $323.59 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $8,128.31 Typical High $16,982.44 | Facility | None | $3,890.45 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $1,445.44 | Professional | None | $245.47 | $251.19 | $1,445.44 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,202.26 Typical High $6,918.31 | Facility | None | $100.00 | $1,202.26 | $6,918.31 |
Blue Shield Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $478.63 | Professional | None | $199.53 | $302.00 | $478.63 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $707.95 | Professional | None | $316.23 | $398.11 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,698.24 Typical High $3,388.44 | Facility | None | $645.65 | $1,698.24 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $758.58 | Professional | None | $251.19 | $380.19 | $758.58 |
Contra Costa Health Setting Professional Modifier None Typical Low $234.42 Median $380.19 Typical High $758.58 | Professional | None | $234.42 | $380.19 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $977.24 | Professional | None | $295.12 | $512.86 | $977.24 |
Lucent Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,073.80 | Professional | None | $3,715.35 | $3,715.35 | $4,073.80 |
Molina Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $660.69 | Professional | None | $398.11 | $398.11 | $660.69 |
Providence Setting Facility Modifier None Typical Low $501.19 Median $1,659.59 Typical High $4,365.16 | Facility | None | $501.19 | $1,659.59 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $676.08 | Professional | None | $251.19 | $380.19 | $676.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,023.29 | $1,584.89 |
United Setting Facility Modifier None Typical Low $549.54 Median $794.33 Typical High $2,290.87 | Facility | None | $549.54 | $794.33 | $2,290.87 |
United Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $812.83 | Professional | None | $239.88 | $389.05 | $812.83 |
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 $120.23 Median $128.82 Typical High $181.97 | Facility | 52 · Reduced service | $120.23 | $128.82 | $181.97 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $47.86 Median $51.29 Typical High $72.44 | Facility | 53 · Discontinued | $47.86 | $51.29 | $72.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $177.83 Median $190.55 Typical High $275.42 | Facility | 54 · Surgery only | $177.83 | $190.55 | $275.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $35.48 Median $38.02 Typical High $54.95 | Facility | 55 · Aftercare only | $35.48 | $38.02 | $54.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.70 Typical High $36.31 | Facility | 56 · Pre-op care only | $23.99 | $25.70 | $36.31 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $177.83 Typical High $257.04 | Facility | 78 · Unplanned return to OR | $165.96 | $177.83 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $147.91 Typical High $181.97 | Professional | 52 · Reduced service | $120.23 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $60.26 Typical High $72.44 | Professional | 53 · Discontinued | $47.86 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $223.87 Typical High $275.42 | Professional | 54 · Surgery only | $177.83 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $45.71 Typical High $54.95 | Professional | 55 · Aftercare only | $35.48 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $30.20 Typical High $36.31 | Professional | 56 · Pre-op care only | $23.99 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $208.93 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $165.96 | $208.93 | $257.04 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $630.96 Typical High $851.14 | Professional | 50 · Both sides | $501.19 | $630.96 | $851.14 |
Where California sits
The same service costs 5.9 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· 31st of 51
$468
AK $1,698UT $288
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.