How much rates vary
Facilitymedian $1,096 · 10th to 90th $91 to $6,607Professionalmedian $112 · 10th to 90th $83 to $282
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 $109.65 Median $7,079.46 Typical High $18,197.01 | Facility | None | $109.65 | $7,079.46 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $162.18 | Professional | None | $87.10 | $109.65 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
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 $85.11 Median $97.72 Typical High $288.40 | Professional | None | $85.11 | $97.72 | $288.40 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,148.15 Typical High $4,570.88 | Facility | None | $100.00 | $1,148.15 | $4,570.88 |
Blue Shield Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $158.49 | Professional | None | $77.62 | $114.82 | $158.49 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $239.88 | Professional | None | $102.33 | $138.04 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $676.08 | Facility | None | $50.12 | $61.66 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $158.49 | Professional | None | $93.33 | $120.23 | $158.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $158.49 | Professional | None | $91.20 | $123.03 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $234.42 | Professional | None | $75.86 | $107.15 | $234.42 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $131.83 | Professional | None | $79.43 | $79.43 | $131.83 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $676.08 | Facility | None | $50.12 | $100.00 | $676.08 |
Providence Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $151.36 | Professional | None | $93.33 | $114.82 | $151.36 |
Sutter Health Plus Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $309.03 | Professional | None | $257.04 | $257.04 | $309.03 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,090.30 | Facility | None | $123.03 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $169.82 | Professional | None | $66.07 | $93.33 | $169.82 |
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 $47.86 Median $52.48 Typical High $61.66 | Facility | 52 · Reduced service | $47.86 | $52.48 | $61.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.05 Median $20.89 Typical High $24.55 | Facility | 53 · Discontinued | $19.05 | $20.89 | $24.55 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $70.79 Median $79.43 Typical High $91.20 | Facility | 54 · Surgery only | $70.79 | $79.43 | $91.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.13 Median $15.85 Typical High $18.62 | Facility | 55 · Aftercare only | $14.13 | $15.85 | $18.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.47 Typical High $12.30 | Facility | 56 · Pre-op care only | $9.55 | $10.47 | $12.30 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $74.13 Typical High $85.11 | Facility | 78 · Unplanned return to OR | $66.07 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $51.29 Typical High $60.26 | Professional | 52 · Reduced service | $43.65 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $20.42 Typical High $23.99 | Professional | 53 · Discontinued | $17.78 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $75.86 Typical High $91.20 | Professional | 54 · Surgery only | $66.07 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $15.49 Typical High $18.20 | Professional | 55 · Aftercare only | $13.18 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.23 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.91 | $10.23 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $70.79 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $61.66 | $70.79 | $85.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $138.04 Typical High $181.97 | Professional | 50 · Both sides | $117.49 | $138.04 | $181.97 |
Where California sits
The same service costs 4.2 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· 30th of 51
$117
AK $324FL $77.62
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.