How much rates vary
Facilitymedian $1,096 · 10th to 90th $135 to $6,607Professionalmedian $380 · 10th to 90th $229 to $1,445
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 $478.63 Median $5,128.61 Typical High $15,135.61 | Facility | None | $478.63 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $616.60 | Professional | None | $229.09 | $354.81 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $1,202.26 | Professional | None | $245.47 | $251.19 | $1,202.26 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,819.70 Typical High $6,456.54 | Facility | None | $100.00 | $1,819.70 | $6,456.54 |
Blue Shield Setting Professional Modifier None Typical Low $199.53 Median $354.81 Typical High $562.34 | Professional | None | $199.53 | $354.81 | $562.34 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $281.84 Median $630.96 Typical High $870.96 | Professional | None | $281.84 | $630.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $295.12 Typical High $741.31 | Facility | None | $56.23 | $295.12 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $707.95 | Professional | None | $229.09 | $398.11 | $707.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $251.19 Median $489.78 Typical High $616.60 | Professional | None | $251.19 | $489.78 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $467.74 Typical High $851.14 | Professional | None | $223.87 | $467.74 | $851.14 |
Lucent Health Setting Professional Modifier None Typical Low $3,715.35 Median $4,265.80 Typical High $4,265.80 | Professional | None | $3,715.35 | $4,265.80 | $4,265.80 |
Molina Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $602.56 | Professional | None | $363.08 | $363.08 | $602.56 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $323.59 Typical High $758.58 | Facility | None | $66.07 | $323.59 | $758.58 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $691.83 | Professional | None | $229.09 | $389.05 | $691.83 |
Sutter Health Plus Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,445.44 | Professional | None | $831.76 | $831.76 | $1,445.44 |
United Setting Facility Modifier None Typical Low $123.03 Median $524.81 Typical High $3,090.30 | Facility | None | $123.03 | $524.81 | $3,090.30 |
United Setting Professional Modifier None Typical Low $208.93 Median $380.19 Typical High $741.31 | Professional | None | $208.93 | $380.19 | $741.31 |
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 $114.82 Median $120.23 Typical High $213.80 | Facility | 52 · Reduced service | $114.82 | $120.23 | $213.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $45.71 Median $48.98 Typical High $85.11 | Facility | 53 · Discontinued | $45.71 | $48.98 | $85.11 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $169.82 Median $181.97 Typical High $316.23 | Facility | 54 · Surgery only | $169.82 | $181.97 | $316.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.88 Median $36.31 Typical High $64.57 | Facility | 55 · Aftercare only | $33.88 | $36.31 | $64.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.99 Typical High $42.66 | Facility | 56 · Pre-op care only | $22.91 | $23.99 | $42.66 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $169.82 Typical High $295.12 | Facility | 78 · Unplanned return to OR | $158.49 | $169.82 | $295.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $169.82 Typical High $213.80 | Professional | 52 · Reduced service | $114.82 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $67.61 Typical High $85.11 | Professional | 53 · Discontinued | $45.71 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $257.04 Typical High $316.23 | Professional | 54 · Surgery only | $169.82 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $51.29 Typical High $64.57 | Professional | 55 · Aftercare only | $33.88 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $33.88 Typical High $42.66 | Professional | 56 · Pre-op care only | $22.91 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $239.88 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $158.49 | $239.88 | $295.12 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $588.84 Typical High $831.76 | Professional | 50 · Both sides | $489.78 | $588.84 | $831.76 |
Where California sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 35th of 51
$398
AK $1,023MD $302
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.