How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,585 to $17,783Professionalmedian $1,905 · 10th to 90th $1,413 to $12,589
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 $6,760.83 Typical High $16,218.10 | Facility | None | $2,398.83 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,513.56 | $1,659.59 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $13,489.63 Typical High $23,442.29 | Facility | None | $6,918.31 | $13,489.63 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $4,365.16 | Professional | None | $1,778.28 | $1,905.46 | $4,365.16 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,311.31 Typical High $19,054.61 | Facility | None | $100.00 | $3,311.31 | $19,054.61 |
Blue Shield Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,819.70 | $2,570.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,819.70 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,754.40 Typical High $10,232.93 | Facility | None | $758.58 | $5,754.40 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $2,691.53 | Professional | None | $1,584.89 | $1,737.80 | $2,691.53 |
Contra Costa Health Setting Professional Modifier None Typical Low $851.14 Median $1,698.24 Typical High $2,137.96 | Professional | None | $851.14 | $1,698.24 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $4,570.88 | Professional | None | $1,412.54 | $1,819.70 | $4,570.88 |
Lucent Health Setting Professional Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $13,182.57 | Professional | None | $12,589.25 | $12,589.25 | $13,182.57 |
Molina Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $5,623.41 Typical High $10,232.93 | Facility | None | $831.76 | $5,623.41 | $10,232.93 |
Providence Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,584.89 | $1,737.80 | $2,570.40 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $7,079.46 Typical High $18,620.87 | Facility | None | $2,884.03 | $7,079.46 | $18,620.87 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,659.59 | $2,691.53 |
5 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 54 · Surgery only Typical Low $1,071.52 Median $1,148.15 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,071.52 | $1,148.15 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $229.09 Typical High $245.47 | Professional | 55 · Aftercare only | $218.78 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $162.18 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,071.52 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,071.52 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,344.23 Typical High $4,365.16 | Professional | 50 · Both sides | $1,698.24 | $2,344.23 | $4,365.16 |
Where California sits
The same service costs 7.8 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
$1,905
AK $6,761TX $871
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.