How much rates vary
Facilitymedian $2,951 · 10th to 90th $794 to $9,550Professionalmedian $631 · 10th to 90th $479 to $4,266
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 $489.78 Median $512.86 Typical High $549.54 | Professional | None | $489.78 | $512.86 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,606.93 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $1,513.56 | Professional | None | $602.56 | $630.96 | $1,513.56 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,187.76 Typical High $7,585.78 | Facility | None | $100.00 | $2,187.76 | $7,585.78 |
Blue Shield Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $794.33 | Professional | None | $389.05 | $562.34 | $794.33 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $724.44 | Professional | None | $467.74 | $676.08 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,511.89 Typical High $4,786.30 | Facility | None | $645.65 | $2,511.89 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $954.99 | Professional | None | $512.86 | $602.56 | $954.99 |
Contra Costa Health Setting Professional Modifier None Typical Low $316.23 Median $645.65 Typical High $812.83 | Professional | None | $316.23 | $645.65 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,348.96 | Professional | None | $549.54 | $676.08 | $1,348.96 |
Lucent Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,786.30 | Professional | None | $4,265.80 | $4,265.80 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
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 $676.08 Median $2,511.89 Typical High $5,128.61 | Facility | None | $676.08 | $2,511.89 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $912.01 | Professional | None | $501.19 | $588.84 | $912.01 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,090.30 | $10,964.78 |
United Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $954.99 | Professional | None | $457.09 | $562.34 | $954.99 |
8 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 $239.88 Median $257.04 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $109.65 | Professional | 53 · Discontinued | $97.72 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $54.95 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $363.08 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $338.84 | $363.08 | $389.05 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $912.01 Typical High $1,513.56 | Professional | 50 · Both sides | $724.44 | $912.01 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $302.00 Median $380.19 Typical High $630.96 | Professional | 62 · Two surgeons | $302.00 | $380.19 | $630.96 |
Where California sits
The same service costs 8.1 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· 38th of 51
$631
AK $2,399TX $295
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.