How much rates vary
Facilitymedian $4,467 · 10th to 90th $617 to $151,356Professionalmedian $1,862 · 10th to 90th $1,230 to $12,303
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 $8,128.31 Typical High $19,054.61 | Facility | None | $1,380.38 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,230.27 | $1,380.38 | $1,548.82 |
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 $1,737.80 Median $1,995.26 Typical High $5,370.32 | Professional | None | $1,737.80 | $1,995.26 | $5,370.32 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,606.93 | Facility | None | $67.61 | $3,090.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $2,884.03 | Professional | None | $1,023.29 | $1,479.11 | $2,884.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,548.82 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $10,000.00 | Facility | None | $660.69 | $1,412.54 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $3,801.89 | Professional | None | $1,288.25 | $1,513.56 | $3,801.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $870.96 Median $1,412.54 Typical High $1,698.24 | Professional | None | $870.96 | $1,412.54 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $3,801.89 | Professional | None | $1,258.93 | $1,584.89 | $3,801.89 |
Lucent Health Setting Professional Modifier None Typical Low $12,302.69 Median $12,589.25 Typical High $12,589.25 | Professional | None | $12,302.69 | $12,589.25 | $12,589.25 |
Molina Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $151,356.12 Typical High $251,188.64 | Facility | None | $851.14 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $3,801.89 | Professional | None | $1,288.25 | $1,479.11 | $3,801.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $4,168.69 | Professional | None | $1,122.02 | $1,584.89 | $4,168.69 |
6 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 $616.60 Median $660.69 Typical High $776.25 | Professional | 52 · Reduced service | $616.60 | $660.69 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $309.03 | Professional | 53 · Discontinued | $245.47 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,000.00 Typical High $1,148.15 | Professional | 54 · Surgery only | $933.25 | $1,000.00 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $199.53 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $131.83 Typical High $154.88 | Professional | 56 · Pre-op care only | $123.03 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $933.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $870.96 | $933.25 | $1,071.52 |
Where California sits
The same service costs 5.4 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· 26th of 51
$1,950
AK $5,370TX $1,000
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.