How much rates vary
Facilitymedian $1,047 · 10th to 90th $158 to $8,710Professionalmedian $209 · 10th to 90th $123 to $708
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 $131.83 Median $208.93 Typical High $371.54 | Professional | None | $131.83 | $208.93 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $7,943.28 Typical High $16,982.44 | Facility | None | $3,630.78 | $7,943.28 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $616.60 | Professional | None | $123.03 | $194.98 | $616.60 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,230.27 Typical High $6,165.95 | Facility | None | $100.00 | $1,230.27 | $6,165.95 |
Blue Shield Setting Professional Modifier None Typical Low $114.82 Median $204.17 Typical High $446.68 | Professional | None | $114.82 | $204.17 | $446.68 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $316.23 | Professional | None | $141.25 | $181.97 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $346.74 Typical High $1,778.28 | Facility | None | $218.78 | $346.74 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $398.11 | Professional | None | $141.25 | $223.87 | $398.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $309.03 | Professional | None | $112.20 | $169.82 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $245.47 Typical High $457.09 | Professional | None | $138.04 | $245.47 | $457.09 |
Lucent Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,548.82 | $1,548.82 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $302.00 | Professional | None | $181.97 | $181.97 | $302.00 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $316.23 Typical High $1,778.28 | Facility | None | $190.55 | $316.23 | $1,778.28 |
Providence Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $398.11 | Professional | None | $138.04 | $213.80 | $398.11 |
Sutter Health Plus Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $707.95 | Professional | None | $436.52 | $436.52 | $707.95 |
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 $112.20 Median $199.53 Typical High $501.19 | Professional | None | $112.20 | $199.53 | $501.19 |
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 $66.07 Median $70.79 Typical High $120.23 | Facility | 52 · Reduced service | $66.07 | $70.79 | $120.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $28.18 Typical High $47.86 | Facility | 53 · Discontinued | $26.30 | $28.18 | $47.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $100.00 Median $107.15 Typical High $177.83 | Facility | 54 · Surgery only | $100.00 | $107.15 | $177.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.95 Median $21.38 Typical High $35.48 | Facility | 55 · Aftercare only | $19.95 | $21.38 | $35.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.13 Typical High $23.99 | Facility | 56 · Pre-op care only | $13.18 | $14.13 | $23.99 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $100.00 Typical High $165.96 | Facility | 78 · Unplanned return to OR | $93.33 | $100.00 | $165.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $95.50 Typical High $112.20 | Professional | 52 · Reduced service | $61.66 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $38.02 Typical High $45.71 | Professional | 53 · Discontinued | $25.12 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $141.25 Typical High $169.82 | Professional | 54 · Surgery only | $93.33 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $28.18 Typical High $33.88 | Professional | 55 · Aftercare only | $18.62 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $19.05 Typical High $22.39 | Professional | 56 · Pre-op care only | $12.59 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $131.83 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $87.10 | $131.83 | $158.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $199.53 Median $309.03 Typical High $549.54 | Professional | 50 · Both sides | $199.53 | $309.03 | $549.54 |
Where California sits
The same service costs 3.5 times more in Wisconsin 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· 38th of 51
$219
WI $575KY $162
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.