How much rates vary
Facilitymedian $4,467 · 10th to 90th $617 to $151,356Professionalmedian $1,862 · 10th to 90th $1,230 to $6,607
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 $1,412.54 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,412.54 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,380.38 | $1,905.46 |
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 $2,089.30 Typical High $5,495.41 | Professional | None | $1,737.80 | $2,089.30 | $5,495.41 |
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 $1,047.13 Median $1,479.11 Typical High $2,884.03 | Professional | None | $1,047.13 | $1,479.11 | $2,884.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,348.96 | $1,621.81 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,445.44 Typical High $10,000.00 | Facility | None | $660.69 | $1,445.44 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $3,890.45 | Professional | None | $1,318.26 | $1,584.89 | $3,890.45 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,548.82 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $3,890.45 | Professional | None | $1,318.26 | $1,659.59 | $3,890.45 |
Lucent Health Setting Professional Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $14,125.38 | Professional | None | $14,125.38 | $14,125.38 | $14,125.38 |
Molina Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $1,318.26 Median $1,513.56 Typical High $3,890.45 | Professional | None | $1,318.26 | $1,513.56 | $3,890.45 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
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 $1,174.90 Median $1,659.59 Typical High $4,365.16 | Professional | None | $1,174.90 | $1,659.59 | $4,365.16 |
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 $645.65 Median $691.83 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $691.83 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $275.42 Typical High $316.23 | Professional | 53 · Discontinued | $257.04 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,023.29 Typical High $1,202.26 | Professional | 54 · Surgery only | $954.99 | $1,023.29 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $204.17 Typical High $239.88 | Professional | 55 · Aftercare only | $190.55 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $138.04 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $954.99 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $891.25 | $954.99 | $1,122.02 |
Where California sits
The same service costs 5.6 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· 31st of 51
$1,905
AK $5,623TX $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.