How much rates vary
Facilitymedian $3,162 · 10th to 90th $955 to $12,589Professionalmedian $631 · 10th to 90th $490 to $4,571
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 $2,398.83 Median $7,762.47 Typical High $18,197.01 | Facility | None | $2,398.83 | $7,762.47 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $977.24 | Professional | None | $501.19 | $588.84 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $10,000.00 Typical High $18,620.87 | Facility | None | $4,570.88 | $10,000.00 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $1,698.24 | Professional | None | $602.56 | $616.60 | $1,698.24 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,162.28 Typical High $9,120.11 | Facility | None | $100.00 | $3,162.28 | $9,120.11 |
Blue Shield Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $851.14 | Professional | None | $436.52 | $630.96 | $851.14 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $912.01 | Professional | None | $616.60 | $776.25 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,412.54 Typical High $3,311.31 | Facility | None | $776.25 | $1,412.54 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $1,023.29 | Professional | None | $524.81 | $630.96 | $1,023.29 |
Contra Costa Health Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $912.01 | Professional | None | $478.63 | $691.83 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,445.44 | Professional | None | $602.56 | $724.44 | $1,445.44 |
Lucent Health Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $5,128.61 | Professional | None | $4,570.88 | $4,570.88 | $5,128.61 |
Molina Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $1,479.11 Typical High $6,309.57 | Facility | None | $758.58 | $1,479.11 | $6,309.57 |
Providence Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $977.24 | Professional | None | $524.81 | $630.96 | $977.24 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,466.84 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,466.84 | $14,454.40 |
United Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $1,023.29 | Professional | None | $478.63 | $602.56 | $1,023.29 |
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 $257.04 Median $275.42 Typical High $295.12 | Professional | 52 · Reduced service | $257.04 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $109.65 Typical High $117.49 | Professional | 53 · Discontinued | $102.33 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $407.38 Typical High $436.52 | Professional | 54 · Surgery only | $389.05 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $58.88 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $380.19 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $363.08 | $380.19 | $407.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $977.24 Typical High $1,548.82 | Professional | 50 · Both sides | $758.58 | $977.24 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $407.38 Typical High $660.69 | Professional | 62 · Two surgeons | $323.59 | $407.38 | $660.69 |
Where California sits
The same service costs 7.2 times more in Alaska than in Utah. 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
$661
AK $2,570UT $355
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.