How much rates vary
Facilitymedian $1,698 · 10th to 90th $513 to $6,607Professionalmedian $234 · 10th to 90th $170 to $1,349
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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $190.55 Typical High $245.47 | Professional | None | $186.21 | $190.55 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $2,137.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $812.83 | Professional | None | $181.97 | $239.88 | $812.83 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,778.28 Typical High $5,011.87 | Facility | None | $100.00 | $1,778.28 | $5,011.87 |
Blue Shield Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $562.34 | Professional | None | $165.96 | $234.42 | $562.34 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $67.61 Median $114.82 Typical High $234.42 | Professional | None | $67.61 | $114.82 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,047.13 Typical High $1,778.28 | Facility | None | $426.58 | $1,047.13 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $549.54 | Professional | None | $186.21 | $223.87 | $549.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $64.57 Median $208.93 Typical High $251.19 | Professional | None | $64.57 | $208.93 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $416.87 | Professional | None | $177.83 | $223.87 | $416.87 |
Lucent Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,445.44 | Professional | None | $1,348.96 | $1,348.96 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $1,096.48 Typical High $2,754.23 | Facility | None | $338.84 | $1,096.48 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $537.03 | Professional | None | $186.21 | $218.78 | $537.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $575.44 | Professional | None | $147.91 | $204.17 | $575.44 |
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 $95.50 Median $95.50 Typical High $102.33 | Professional | 52 · Reduced service | $95.50 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $41.69 | Professional | 53 · Discontinued | $38.02 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $154.88 | Professional | 54 · Surgery only | $141.25 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $30.90 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $20.89 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $131.83 | $131.83 | $144.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $302.00 Typical High $660.69 | Professional | 50 · Both sides | $239.88 | $302.00 | $660.69 |
Where California sits
The same service costs 8.9 times more in Oklahoma 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· 20th of 51
$324
OK $1,413UT $158
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.