How much rates vary
Facilitymedian $2,042 · 10th to 90th $468 to $8,318Professionalmedian $275 · 10th to 90th $158 to $1,175
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 $158.49 Median $257.04 Typical High $407.38 | Professional | None | $158.49 | $257.04 | $407.38 |
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 $169.82 Median $173.78 Typical High $870.96 | Professional | None | $169.82 | $173.78 | $870.96 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $6,165.95 | Facility | None | $100.00 | $794.33 | $6,165.95 |
Blue Shield Setting Professional Modifier None Typical Low $134.90 Median $257.04 Typical High $407.38 | Professional | None | $134.90 | $257.04 | $407.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $489.78 | Professional | None | $173.78 | $263.03 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,698.24 Typical High $3,311.31 | Facility | None | $575.44 | $1,698.24 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $524.81 | Professional | None | $162.18 | $281.84 | $524.81 |
Contra Costa Health Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $524.81 | Professional | None | $154.88 | $208.93 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $354.81 Typical High $660.69 | Professional | None | $165.96 | $354.81 | $660.69 |
Lucent Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,818.38 | Professional | None | $2,454.71 | $2,454.71 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $457.09 | Professional | None | $275.42 | $275.42 | $457.09 |
Providence Setting Facility Modifier None Typical Low $380.19 Median $1,621.81 Typical High $4,365.16 | Facility | None | $380.19 | $1,621.81 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $489.78 | Professional | None | $162.18 | $281.84 | $489.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,071.52 | Professional | None | $602.56 | $602.56 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,090.30 | $10,964.78 |
United Setting Professional Modifier None Typical Low $144.54 Median $275.42 Typical High $562.34 | Professional | None | $144.54 | $275.42 | $562.34 |
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 $79.43 Median $85.11 Typical High $154.88 | Facility | 52 · Reduced service | $79.43 | $85.11 | $154.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $31.62 Median $34.67 Typical High $61.66 | Facility | 53 · Discontinued | $31.62 | $34.67 | $61.66 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $128.82 Typical High $229.09 | Facility | 54 · Surgery only | $117.49 | $128.82 | $229.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $25.70 Typical High $45.71 | Facility | 55 · Aftercare only | $23.99 | $25.70 | $45.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.98 Typical High $30.90 | Facility | 56 · Pre-op care only | $15.85 | $16.98 | $30.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $120.23 Typical High $213.80 | Facility | 78 · Unplanned return to OR | $109.65 | $120.23 | $213.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $120.23 Typical High $154.88 | Professional | 52 · Reduced service | $79.43 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $48.98 Typical High $61.66 | Professional | 53 · Discontinued | $31.62 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $181.97 Typical High $229.09 | Professional | 54 · Surgery only | $117.49 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $36.31 Typical High $45.71 | Professional | 55 · Aftercare only | $23.99 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $24.55 Typical High $30.90 | Professional | 56 · Pre-op care only | $15.85 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $169.82 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $109.65 | $169.82 | $213.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $501.19 Typical High $588.84 | Professional | 50 · Both sides | $354.81 | $501.19 | $588.84 |
Where California sits
The same service costs 6.3 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $4,654MT $736
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.