How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,380 to $16,982Professionalmedian $1,862 · 10th to 90th $1,380 to $12,023
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 $9,120.11 Typical High $21,379.62 | Facility | None | $2,398.83 | $9,120.11 | $21,379.62 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,412.54 | $1,584.89 | $3,090.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $11,481.54 Typical High $20,417.38 | Facility | None | $5,888.44 | $11,481.54 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $6,165.95 | Professional | None | $1,584.89 | $1,737.80 | $6,165.95 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,949.84 Typical High $18,620.87 | Facility | None | $100.00 | $1,949.84 | $18,620.87 |
Blue Shield Setting Professional Modifier None Typical Low $1,288.25 Median $1,862.09 Typical High $4,466.84 | Professional | None | $1,288.25 | $1,862.09 | $4,466.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,778.28 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $4,786.30 Typical High $9,120.11 | Facility | None | $1,548.82 | $4,786.30 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $4,265.80 | Professional | None | $1,318.26 | $1,698.24 | $4,265.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,737.80 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,737.80 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $4,677.35 | Professional | None | $1,479.11 | $1,905.46 | $4,677.35 |
Lucent Health Setting Professional Modifier None Typical Low $12,022.64 Median $12,022.64 Typical High $12,589.25 | Professional | None | $12,022.64 | $12,022.64 | $12,589.25 |
Molina Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Providence Setting Facility Modifier None Typical Low $1,479.11 Median $4,786.30 Typical High $11,220.18 | Facility | None | $1,479.11 | $4,786.30 | $11,220.18 |
Providence Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $4,265.80 | Professional | None | $1,318.26 | $1,698.24 | $4,265.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,754.40 | $17,378.01 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $4,786.30 | Professional | None | $1,230.27 | $1,659.59 | $4,786.30 |
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 $707.95 Median $707.95 Typical High $812.83 | Professional | 52 · Reduced service | $707.95 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $331.13 | Professional | 53 · Discontinued | $281.84 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $245.47 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $162.18 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $977.24 Typical High $2,344.23 | Professional | 62 · Two surgeons | $776.25 | $977.24 | $2,344.23 |
Where California sits
The same service costs 6.3 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· 33rd of 51
$2,089
AK $6,457UT $1,023
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.