How much rates vary
Facilitymedian $2,399 · 10th to 90th $1,288 to $9,550Professionalmedian $661 · 10th to 90th $537 to $2,291
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 $537.03 Median $588.84 Typical High $977.24 | Professional | None | $537.03 | $588.84 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,128.31 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,737.80 | Professional | None | $645.65 | $660.69 | $1,737.80 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,162.28 Typical High $7,943.28 | Facility | None | $100.00 | $3,162.28 | $7,943.28 |
Blue Shield Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $954.99 | Professional | None | $467.74 | $691.83 | $954.99 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $954.99 | Professional | None | $630.96 | $794.33 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,511.89 Typical High $5,128.61 | Facility | None | $676.08 | $2,511.89 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $1,047.13 | Professional | None | $588.84 | $660.69 | $1,047.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $954.99 | Professional | None | $501.19 | $707.95 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,905.46 | Professional | None | $602.56 | $741.31 | $1,905.46 |
Lucent Health 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 |
Molina Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
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 $724.44 Median $2,511.89 Typical High $6,165.95 | Facility | None | $724.44 | $2,511.89 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $1,000.00 | Professional | None | $588.84 | $645.65 | $1,000.00 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $1,862.09 Typical High $7,413.10 | Facility | None | $1,288.25 | $1,862.09 | $7,413.10 |
United Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $1,047.13 | Professional | None | $489.78 | $616.60 | $1,047.13 |
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 $275.42 Median $288.40 Typical High $309.03 | Professional | 52 · Reduced service | $275.42 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $117.49 Typical High $125.89 | Professional | 53 · Discontinued | $109.65 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $436.52 Typical High $467.74 | Professional | 54 · Surgery only | $407.38 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $87.10 Typical High $93.33 | Professional | 55 · Aftercare only | $81.28 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $58.88 Typical High $63.10 | Professional | 56 · Pre-op care only | $54.95 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $407.38 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $380.19 | $407.38 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $977.24 Typical High $1,584.89 | Professional | 50 · Both sides | $776.25 | $977.24 | $1,584.89 |
Where California sits
The same service costs 7.4 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
$708
AK $2,630TX $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.