How much rates vary
Facilitymedian $2,239 · 10th to 90th $427 to $6,607Professionalmedian $437 · 10th to 90th $339 to $3,020
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 $338.84 Median $354.81 Typical High $389.05 | Professional | None | $338.84 | $354.81 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,128.61 Typical High $10,471.29 | Facility | None | $2,137.96 | $5,128.61 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $436.52 Typical High $1,148.15 | Professional | None | $426.58 | $436.52 | $1,148.15 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,258.93 Typical High $5,128.61 | Facility | None | $100.00 | $1,258.93 | $5,128.61 |
Blue Shield Setting Professional Modifier None Typical Low $275.42 Median $407.38 Typical High $562.34 | Professional | None | $275.42 | $407.38 | $562.34 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $602.56 | Professional | None | $407.38 | $549.54 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $2,398.83 Typical High $4,073.80 | Facility | None | $426.58 | $2,398.83 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $676.08 | Professional | None | $354.81 | $407.38 | $676.08 |
Contra Costa Health Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $602.56 | Professional | None | $316.23 | $489.78 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $1,000.00 | Professional | None | $407.38 | $501.19 | $1,000.00 |
Lucent Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,467.37 | Professional | None | $3,019.95 | $3,019.95 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
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 $457.09 Median $2,290.87 Typical High $4,265.80 | Facility | None | $457.09 | $2,290.87 | $4,265.80 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $630.96 | Professional | None | $354.81 | $407.38 | $630.96 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,230.27 Typical High $4,897.79 | Facility | None | $398.11 | $1,230.27 | $4,897.79 |
United Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $676.08 | Professional | None | $316.23 | $398.11 | $676.08 |
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 $169.82 Median $177.83 Typical High $194.98 | Professional | 52 · Reduced service | $169.82 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $72.44 Typical High $77.62 | Professional | 53 · Discontinued | $67.61 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $269.15 Typical High $288.40 | Professional | 54 · Surgery only | $251.19 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $53.70 Typical High $58.88 | Professional | 55 · Aftercare only | $50.12 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $35.48 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.88 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $251.19 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $234.42 | $251.19 | $269.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $616.60 Typical High $1,047.13 | Professional | 50 · Both sides | $467.74 | $616.60 | $1,047.13 |
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
$437
AK $1,698TX $209
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.