How much rates vary
Facilitymedian $3,388 · 10th to 90th $933 to $12,589Professionalmedian $1,000 · 10th to 90th $776 to $7,244
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 $2,238.72 Median $7,585.78 Typical High $18,197.01 | Facility | None | $2,238.72 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $977.24 | Professional | None | $776.25 | $812.83 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,232.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $3,801.89 | Professional | None | $776.25 | $870.96 | $3,801.89 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,737.80 Typical High $9,332.54 | Facility | None | $100.00 | $1,737.80 | $9,332.54 |
Blue Shield Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,318.26 | Professional | None | $630.96 | $912.01 | $1,318.26 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,513.56 | Professional | None | $977.24 | $1,202.26 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,951.21 Typical High $4,786.30 | Facility | None | $758.58 | $2,951.21 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,698.24 | Professional | None | $870.96 | $1,000.00 | $1,698.24 |
Contra Costa Health Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,288.25 | Professional | None | $794.33 | $1,174.90 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $2,884.03 | Professional | None | $891.25 | $1,071.52 | $2,884.03 |
Lucent Health Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,943.28 | Professional | None | $7,244.36 | $7,244.36 | $7,943.28 |
Molina Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $2,951.21 Typical High $6,025.60 | Facility | None | $794.33 | $2,951.21 | $6,025.60 |
Providence Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,659.59 | Professional | None | $870.96 | $1,000.00 | $1,659.59 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,365.16 | $14,454.40 |
United Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,905.46 | Professional | None | $776.25 | $977.24 | $1,905.46 |
7 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 Professional Modifier 52 · Reduced service Typical Low $389.05 Median $407.38 Typical High $426.58 | Professional | 52 · Reduced service | $389.05 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $169.82 | Professional | 53 · Discontinued | $154.88 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $616.60 Typical High $645.65 | Professional | 54 · Surgery only | $575.44 | $616.60 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $123.03 Typical High $128.82 | Professional | 55 · Aftercare only | $114.82 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $85.11 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $575.44 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $537.03 | $575.44 | $602.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $676.08 Typical High $1,047.13 | Professional | 62 · Two surgeons | $537.03 | $676.08 | $1,047.13 |
Where California sits
The same service costs 8.3 times more in Alaska than in Texas. 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· 32nd of 51
$1,148
AK $4,074TX $490
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.