How much rates vary
Facilitymedian $3,311 · 10th to 90th $676 to $9,550Professionalmedian $1,072 · 10th to 90th $589 to $7,762
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 $6,760.83 Typical High $16,218.10 | Facility | None | $2,238.72 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $954.99 | Professional | None | $851.14 | $891.25 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,128.31 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $2,290.87 | Professional | None | $870.96 | $1,071.52 | $2,290.87 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,949.84 Typical High $7,585.78 | Facility | None | $100.00 | $1,949.84 | $7,585.78 |
Blue Shield Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $1,047.13 | Professional | None | $512.86 | $758.58 | $1,047.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,258.93 | Professional | None | $758.58 | $1,096.48 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,467.37 Typical High $5,888.44 | Facility | None | $645.65 | $3,467.37 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $1,071.52 Typical High $1,659.59 | Professional | None | $575.44 | $1,071.52 | $1,659.59 |
Contra Costa Health Setting Professional Modifier None Typical Low $501.19 Median $1,122.02 Typical High $1,412.54 | Professional | None | $501.19 | $1,122.02 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $2,454.71 | Professional | None | $933.25 | $1,202.26 | $2,454.71 |
Lucent Health Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $8,511.38 | Professional | None | $7,762.47 | $7,762.47 | $8,511.38 |
Molina Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $758.58 Median $3,311.31 Typical High $6,456.54 | Facility | None | $758.58 | $3,311.31 | $6,456.54 |
Providence Setting Professional Modifier None Typical Low $562.34 Median $1,071.52 Typical High $1,659.59 | Professional | None | $562.34 | $1,071.52 | $1,659.59 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
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 $645.65 Median $1,000.00 Typical High $1,737.80 | Professional | None | $645.65 | $1,000.00 | $1,737.80 |
6 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 $426.58 Median $446.68 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $676.08 Typical High $707.95 | Professional | 54 · Surgery only | $630.96 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $134.90 Typical High $141.25 | Professional | 55 · Aftercare only | $125.89 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $95.50 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $630.96 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $588.84 | $630.96 | $660.69 |
Where California sits
The same service costs 7.8 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· 36th of 51
$1,072
AK $4,365TX $562
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.