How much rates vary
Facilitymedian $4,169 · 10th to 90th $708 to $10,471Professionalmedian $398 · 10th to 90th $316 to $3,388
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 $323.59 Median $346.74 Typical High $380.19 | Professional | None | $323.59 | $346.74 | $380.19 |
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 $354.81 Median $363.08 Typical High $954.99 | Professional | None | $354.81 | $363.08 | $954.99 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,258.93 Typical High $7,585.78 | Facility | None | $100.00 | $1,258.93 | $7,585.78 |
Blue Shield Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $524.81 | Professional | None | $257.04 | $371.54 | $524.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $524.81 | Professional | None | $263.03 | $426.58 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,370.32 Typical High $9,120.11 | Facility | None | $645.65 | $5,370.32 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $645.65 | Professional | None | $346.74 | $398.11 | $645.65 |
Contra Costa Health Setting Professional Modifier None Typical Low $173.78 Median $467.74 Typical High $588.84 | Professional | None | $173.78 | $467.74 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $954.99 | Professional | None | $398.11 | $489.78 | $954.99 |
Lucent Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,388.44 | $3,801.89 | $3,801.89 |
Molina Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $549.54 Median $4,897.79 Typical High $8,912.51 | Facility | None | $549.54 | $4,897.79 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $616.60 | Professional | None | $338.84 | $398.11 | $616.60 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $11,481.54 | Facility | None | $1,258.93 | $3,090.30 | $11,481.54 |
United Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $645.65 | Professional | None | $302.00 | $380.19 | $645.65 |
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 $162.18 Median $173.78 Typical High $186.21 | Professional | 52 · Reduced service | $162.18 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $69.18 Typical High $75.86 | Professional | 53 · Discontinued | $64.57 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $263.03 Typical High $281.84 | Professional | 54 · Surgery only | $245.47 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $52.48 Typical High $56.23 | Professional | 55 · Aftercare only | $48.98 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $34.67 Typical High $38.02 | Professional | 56 · Pre-op care only | $32.36 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $245.47 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $229.09 | $245.47 | $263.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $602.56 Typical High $1,174.90 | Professional | 50 · Both sides | $489.78 | $602.56 | $1,174.90 |
Where California sits
The same service costs 7.2 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· 41st of 51
$398
AK $1,622TX $224
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.