How much rates vary
Facilitymedian $1,514 · 10th to 90th $200 to $6,310Professionalmedian $776 · 10th to 90th $575 to $5,012
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 $588.84 Median $630.96 Typical High $676.08 | Professional | None | $588.84 | $630.96 | $676.08 |
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 $758.58 Median $776.25 Typical High $1,905.46 | Professional | None | $758.58 | $776.25 | $1,905.46 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,479.11 Typical High $5,248.07 | Facility | None | $100.00 | $1,479.11 | $5,248.07 |
Blue Shield Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $1,000.00 | Professional | None | $489.78 | $724.44 | $1,000.00 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $851.14 | Professional | None | $489.78 | $707.95 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,348.96 Typical High $2,187.76 | Facility | None | $426.58 | $1,348.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,122.02 | Professional | None | $630.96 | $707.95 | $1,122.02 |
Contra Costa Health Setting Professional Modifier None Typical Low $331.13 Median $758.58 Typical High $954.99 | Professional | None | $331.13 | $758.58 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,584.89 | Professional | None | $630.96 | $794.33 | $1,584.89 |
Lucent Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,623.41 | Professional | None | $5,011.87 | $5,011.87 | $5,623.41 |
Molina Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
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 $489.78 Median $1,348.96 Typical High $2,884.03 | Facility | None | $489.78 | $1,348.96 | $2,884.03 |
Providence Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $1,071.52 | Professional | None | $630.96 | $691.83 | $1,071.52 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,090.30 | Facility | None | $123.03 | $549.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,122.02 | Professional | None | $537.03 | $676.08 | $1,122.02 |
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 $295.12 Median $316.23 Typical High $338.84 | Professional | 52 · Reduced service | $295.12 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $125.89 Typical High $134.90 | Professional | 53 · Discontinued | $117.49 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $467.74 Typical High $501.19 | Professional | 54 · Surgery only | $436.52 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $100.00 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $67.61 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $436.52 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $407.38 | $436.52 | $467.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,071.52 Typical High $1,778.28 | Professional | 50 · Both sides | $851.14 | $1,071.52 | $1,778.28 |
Where California sits
The same service costs 8.5 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· 35th of 51
$776
AK $2,818TX $331
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.