How much rates vary
Facilitymedian $6,166 · 10th to 90th $631 to $64,565Professionalmedian $2,138 · 10th to 90th $1,479 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 $1,621.81 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,621.81 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,479.11 | $1,584.89 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $13,182.57 Typical High $28,840.32 | Facility | None | $6,918.31 | $13,182.57 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $2,344.23 Typical High $6,309.57 | Professional | None | $2,041.74 | $2,344.23 | $6,309.57 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $4,168.69 Typical High $8,709.64 | Facility | None | $67.61 | $4,168.69 | $8,709.64 |
Blue Shield Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $3,388.44 | Professional | None | $1,202.26 | $1,698.24 | $3,388.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $3,090.30 | Professional | None | $1,513.56 | $1,819.70 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,348.96 Typical High $10,000.00 | Facility | None | $660.69 | $1,348.96 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $4,466.84 | Professional | None | $1,513.56 | $1,819.70 | $4,466.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $2,137.96 | Professional | None | $1,621.81 | $1,778.28 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $4,365.16 | Professional | None | $1,479.11 | $1,862.09 | $4,365.16 |
Lucent Health Setting Professional Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $13,489.63 | Professional | None | $12,589.25 | $12,589.25 | $13,489.63 |
Molina Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $812.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $4,466.84 | Professional | None | $1,513.56 | $1,737.80 | $4,466.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
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 $1,318.26 Median $1,862.09 Typical High $4,897.79 | Professional | None | $1,318.26 | $1,862.09 | $4,897.79 |
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 $741.31 Median $776.25 Typical High $912.01 | Professional | 52 · Reduced service | $741.31 | $776.25 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $316.23 Typical High $363.08 | Professional | 53 · Discontinued | $295.12 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,174.90 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,096.48 | $1,174.90 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $234.42 Typical High $269.15 | Professional | 55 · Aftercare only | $218.78 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $158.49 Typical High $181.97 | Professional | 56 · Pre-op care only | $147.91 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,096.48 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,096.48 | $1,258.93 |
Where California sits
The same service costs 5.5 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· 17th of 51
$2,399
AK $6,457TX $1,175
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.