How much rates vary
Facilitymedian $417 · 10th to 90th $110 to $5,754Professionalmedian $138 · 10th to 90th $102 to $490
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 $104.71 Median $138.04 Typical High $251.19 | Professional | None | $104.71 | $138.04 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $120.23 Typical High $138.04 | Professional | None | $60.26 | $120.23 | $138.04 |
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 $100.00 Median $107.15 Typical High $426.58 | Professional | None | $100.00 | $107.15 | $426.58 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $426.58 Typical High $1,479.11 | Facility | None | $97.72 | $426.58 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $190.55 | Professional | None | $85.11 | $125.89 | $190.55 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $223.87 | Professional | None | $125.89 | $169.82 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $154.88 Typical High $323.59 | Facility | None | $53.70 | $154.88 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $234.42 | Professional | None | $107.15 | $147.91 | $234.42 |
Contra Costa Health Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $204.17 | Professional | None | $125.89 | $141.25 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $346.74 | Professional | None | $109.65 | $162.18 | $346.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,230.27 | Professional | None | $1,202.26 | $1,202.26 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $204.17 | Professional | None | $120.23 | $120.23 | $204.17 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $158.49 Typical High $331.13 | Facility | None | $61.66 | $158.49 | $331.13 |
Providence Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $234.42 | Professional | None | $107.15 | $138.04 | $234.42 |
Sutter Health Plus Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $489.78 | Professional | None | $389.05 | $389.05 | $489.78 |
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 $93.33 Median $131.83 Typical High $257.04 | Professional | None | $93.33 | $131.83 | $257.04 |
15 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 $52.48 Median $56.23 Typical High $72.44 | Facility | 52 · Reduced service | $52.48 | $56.23 | $72.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.89 Median $22.39 Typical High $28.84 | Facility | 53 · Discontinued | $20.89 | $22.39 | $28.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $77.62 Median $85.11 Typical High $107.15 | Facility | 54 · Surgery only | $77.62 | $85.11 | $107.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.49 Median $16.98 Typical High $21.38 | Facility | 55 · Aftercare only | $15.49 | $16.98 | $21.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.22 Typical High $14.45 | Facility | 56 · Pre-op care only | $10.47 | $11.22 | $14.45 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $79.43 Typical High $100.00 | Facility | 78 · Unplanned return to OR | $72.44 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $57.54 Typical High $72.44 | Professional | 52 · Reduced service | $52.48 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.91 Typical High $28.84 | Professional | 53 · Discontinued | $20.89 | $22.91 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $87.10 Typical High $107.15 | Professional | 54 · Surgery only | $77.62 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $17.38 Typical High $21.38 | Professional | 55 · Aftercare only | $15.49 | $17.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.48 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.47 | $11.48 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $81.28 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $72.44 | $81.28 | $100.00 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $181.97 Typical High $194.98 | Professional | 50 · Both sides | $169.82 | $181.97 | $194.98 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 79 · Unrelated procedure after surgery | $181.97 | $181.97 | $181.97 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $213.80 Typical High $275.42 | Professional | 50 · Both sides | $169.82 | $213.80 | $275.42 |
Where California sits
The same service costs 4.1 times more in Alaska than in Florida. 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· 38th of 51
$145
AK $468FL $115
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.