How much rates vary
Facilitymedian $5,754 · 10th to 90th $617 to $151,356Professionalmedian $4,169 · 10th to 90th $3,090 to $23,442
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 $3,162.28 Median $8,128.31 Typical High $19,054.61 | Facility | None | $3,162.28 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $3,090.30 Median $3,235.94 Typical High $4,786.30 | Professional | None | $3,090.30 | $3,235.94 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,762.47 Median $16,595.87 Typical High $29,512.09 | Facility | None | $7,762.47 | $16,595.87 | $29,512.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,073.80 Median $4,677.35 Typical High $12,882.50 | Professional | None | $4,073.80 | $4,677.35 | $12,882.50 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $6,760.83 Typical High $14,125.38 | Facility | None | $67.61 | $6,760.83 | $14,125.38 |
Blue Shield Setting Professional Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $6,918.31 | Professional | None | $2,511.89 | $3,630.78 | $6,918.31 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,818.38 Median $3,715.35 Typical High $4,786.30 | Professional | None | $2,818.38 | $3,715.35 | $4,786.30 |
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 $3,235.94 Median $3,890.45 Typical High $9,772.37 | Professional | None | $3,235.94 | $3,890.45 | $9,772.37 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,818.38 Median $3,630.78 Typical High $4,265.80 | Professional | None | $2,818.38 | $3,630.78 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,884.03 Median $3,801.89 Typical High $8,912.51 | Professional | None | $2,884.03 | $3,801.89 | $8,912.51 |
Lucent Health Setting Professional Modifier None Typical Low $23,442.29 Median $27,542.29 Typical High $27,542.29 | Professional | None | $23,442.29 | $27,542.29 | $27,542.29 |
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 $3,090.30 Median $3,801.89 Typical High $9,772.37 | Professional | None | $3,090.30 | $3,801.89 | $9,772.37 |
Sutter Health Plus Setting Professional Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $10,715.19 | Professional | None | $10,715.19 | $10,715.19 | $10,715.19 |
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 $2,754.23 Median $3,981.07 Typical High $10,232.93 | Professional | None | $2,754.23 | $3,981.07 | $10,232.93 |
5 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 $1,513.56 Median $1,584.89 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,513.56 | $1,584.89 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $630.96 Typical High $758.58 | Professional | 53 · Discontinued | $602.56 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,398.83 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,290.87 | $2,398.83 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $478.63 Typical High $562.34 | Professional | 55 · Aftercare only | $457.09 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $316.23 Typical High $380.19 | Professional | 56 · Pre-op care only | $302.00 | $316.23 | $380.19 |
Where California sits
The same service costs 7.4 times more in Alaska than in Arkansas. 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· 29th of 51
$4,365
AK $13,490AR $1,820
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.