How much rates vary
Facilitymedian $1,259 · 10th to 90th $229 to $7,244Professionalmedian $204 · 10th to 90th $123 to $851
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 $123.03 Median $204.17 Typical High $363.08 | Professional | None | $123.03 | $204.17 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $2,137.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $602.56 | Professional | None | $125.89 | $204.17 | $602.56 |
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 $104.71 Median $186.21 Typical High $416.87 | Professional | None | $104.71 | $186.21 | $416.87 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $67.61 Median $169.82 Typical High $309.03 | Professional | None | $67.61 | $169.82 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $354.81 Typical High $2,691.53 | Facility | None | $218.78 | $354.81 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $389.05 | Professional | None | $128.82 | $208.93 | $389.05 |
Contra Costa Health Setting Professional Modifier None Typical Low $52.48 Median $165.96 Typical High $302.00 | Professional | None | $52.48 | $165.96 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $239.88 Typical High $426.58 | Professional | None | $131.83 | $239.88 | $426.58 |
Lucent Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,479.11 | $1,479.11 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $295.12 | Professional | None | $173.78 | $173.78 | $295.12 |
Providence Setting Facility Modifier None Typical Low $186.21 Median $316.23 Typical High $2,398.83 | Facility | None | $186.21 | $316.23 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $389.05 | Professional | None | $128.82 | $204.17 | $389.05 |
Sutter Health Plus Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $691.83 | Professional | None | $416.87 | $416.87 | $691.83 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $104.71 Median $190.55 Typical High $478.63 | Professional | None | $104.71 | $190.55 | $478.63 |
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 $61.66 Median $66.07 Typical High $114.82 | Facility | 52 · Reduced service | $61.66 | $66.07 | $114.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $24.55 Median $26.92 Typical High $45.71 | Facility | 53 · Discontinued | $24.55 | $26.92 | $45.71 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $93.33 Median $100.00 Typical High $169.82 | Facility | 54 · Surgery only | $93.33 | $100.00 | $169.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $19.95 Typical High $33.88 | Facility | 55 · Aftercare only | $18.62 | $19.95 | $33.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.49 Typical High $22.91 | Facility | 56 · Pre-op care only | $12.30 | $13.49 | $22.91 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $93.33 Typical High $158.49 | Facility | 78 · Unplanned return to OR | $87.10 | $93.33 | $158.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $91.20 Typical High $109.65 | Professional | 52 · Reduced service | $58.88 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $36.31 Typical High $43.65 | Professional | 53 · Discontinued | $23.99 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $138.04 Typical High $165.96 | Professional | 54 · Surgery only | $89.13 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $27.54 Typical High $33.11 | Professional | 55 · Aftercare only | $17.78 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $18.20 Typical High $21.88 | Professional | 56 · Pre-op care only | $11.75 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $128.82 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $83.18 | $128.82 | $154.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $275.42 Typical High $524.81 | Professional | 50 · Both sides | $186.21 | $275.42 | $524.81 |
Where California sits
The same service costs 3.9 times more in Oklahoma 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· 40th of 51
$214
OK $646KY $166
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.