How much rates vary
Facilitymedian $537 · 10th to 90th $151 to $5,888Professionalmedian $178 · 10th to 90th $105 to $724
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 $199.53 Median $5,011.87 Typical High $15,135.61 | Facility | None | $199.53 | $5,011.87 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $323.59 | Professional | None | $109.65 | $177.83 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
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 $104.71 Median $114.82 Typical High $724.44 | Professional | None | $104.71 | $114.82 | $724.44 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $416.87 Typical High $1,548.82 | Facility | None | $97.72 | $416.87 | $1,548.82 |
Blue Shield Setting Professional Modifier None Typical Low $93.33 Median $165.96 Typical High $363.08 | Professional | None | $93.33 | $165.96 | $363.08 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $63.10 Median $128.82 Typical High $275.42 | Professional | None | $63.10 | $128.82 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $218.78 Typical High $457.09 | Facility | None | $53.70 | $218.78 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $338.84 | Professional | None | $114.82 | $181.97 | $338.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $56.23 Median $158.49 Typical High $269.15 | Professional | None | $56.23 | $158.49 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $416.87 | Professional | None | $128.82 | $213.80 | $416.87 |
Lucent Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,318.26 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $263.03 | Professional | None | $154.88 | $154.88 | $263.03 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $218.78 Typical High $467.74 | Facility | None | $61.66 | $218.78 | $467.74 |
Providence Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $346.74 | Professional | None | $114.82 | $181.97 | $346.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $616.60 | Professional | None | $398.11 | $398.11 | $616.60 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $4,677.35 | Facility | None | $398.11 | $1,202.26 | $4,677.35 |
United Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $436.52 | Professional | None | $100.00 | $173.78 | $436.52 |
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 $54.95 Median $58.88 Typical High $95.50 | Facility | 52 · Reduced service | $54.95 | $58.88 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $23.44 Typical High $38.02 | Facility | 53 · Discontinued | $21.88 | $23.44 | $38.02 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $83.18 Median $87.10 Typical High $144.54 | Facility | 54 · Surgery only | $83.18 | $87.10 | $144.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.60 Median $17.78 Typical High $28.84 | Facility | 55 · Aftercare only | $16.60 | $17.78 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.75 Typical High $19.05 | Facility | 56 · Pre-op care only | $10.96 | $11.75 | $19.05 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $83.18 Typical High $134.90 | Facility | 78 · Unplanned return to OR | $77.62 | $83.18 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $79.43 Typical High $95.50 | Professional | 52 · Reduced service | $54.95 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $31.62 Typical High $38.02 | Professional | 53 · Discontinued | $21.88 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $117.49 Typical High $144.54 | Professional | 54 · Surgery only | $83.18 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $23.44 Typical High $28.84 | Professional | 55 · Aftercare only | $16.60 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $15.85 Typical High $19.05 | Professional | 56 · Pre-op care only | $10.96 | $15.85 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $109.65 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $77.62 | $109.65 | $134.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $245.47 Typical High $630.96 | Professional | 50 · Both sides | $169.82 | $245.47 | $630.96 |
Where California sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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
$191
AK $513KY $126
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.