How much rates vary
Facilitymedian $1,660 · 10th to 90th $550 to $6,607Professionalmedian $525 · 10th to 90th $407 to $3,631
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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $467.74 | Professional | None | $407.38 | $436.52 | $467.74 |
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 $501.19 Median $524.81 Typical High $1,258.93 | Professional | None | $501.19 | $524.81 | $1,258.93 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,513.56 Typical High $5,248.07 | Facility | None | $100.00 | $1,513.56 | $5,248.07 |
Blue Shield Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $691.83 | Professional | None | $331.13 | $489.78 | $691.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $275.42 Median $512.86 Typical High $645.65 | Professional | None | $275.42 | $512.86 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,348.96 Typical High $2,691.53 | Facility | None | $426.58 | $1,348.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $812.83 | Professional | None | $426.58 | $489.78 | $812.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $234.42 Median $575.44 Typical High $691.83 | Professional | None | $234.42 | $575.44 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $1,174.90 | Professional | None | $489.78 | $602.56 | $1,174.90 |
Lucent Health Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,168.69 | Professional | None | $3,630.78 | $3,630.78 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $1,348.96 Typical High $3,548.13 | Facility | None | $478.63 | $1,348.96 | $3,548.13 |
Providence Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $776.25 | Professional | None | $426.58 | $489.78 | $776.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $380.19 Median $478.63 Typical High $812.83 | Professional | None | $380.19 | $478.63 | $812.83 |
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 $204.17 Median $218.78 Typical High $234.42 | Professional | 52 · Reduced service | $204.17 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $93.33 | Professional | 53 · Discontinued | $81.28 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $354.81 | Professional | 54 · Surgery only | $302.00 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $64.57 Typical High $70.79 | Professional | 55 · Aftercare only | $60.26 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $46.77 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $302.00 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $281.84 | $302.00 | $331.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $741.31 Typical High $1,258.93 | Professional | 50 · Both sides | $575.44 | $741.31 | $1,258.93 |
Where California sits
The same service costs 7.6 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· 39th of 51
$537
AK $2,042TX $269
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.