How much rates vary
Facilitymedian $5,129 · 10th to 90th $617 to $151,356Professionalmedian $2,754 · 10th to 90th $1,820 to $10,000
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 $2,089.30 Median $8,128.31 Typical High $19,054.61 | Facility | None | $2,089.30 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,905.46 | $2,041.74 | $2,691.53 |
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 $2,398.83 Median $3,019.95 Typical High $8,128.31 | Professional | None | $2,398.83 | $3,019.95 | $8,128.31 |
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 $1,348.96 Median $1,949.84 Typical High $3,801.89 | Professional | None | $1,348.96 | $1,949.84 | $3,801.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $3,548.13 | Professional | None | $1,949.84 | $2,398.83 | $3,548.13 |
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 $1,995.26 Median $2,344.23 Typical High $6,025.60 | Professional | None | $1,995.26 | $2,344.23 | $6,025.60 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $2,818.38 | Professional | None | $1,862.09 | $2,344.23 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $6,025.60 | Professional | None | $1,862.09 | $2,454.71 | $6,025.60 |
Lucent Health Setting Professional Modifier None Typical Low $19,054.61 Median $19,054.61 Typical High $19,054.61 | Professional | None | $19,054.61 | $19,054.61 | $19,054.61 |
Molina Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
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 $1,995.26 Median $2,238.72 Typical High $6,025.60 | Professional | None | $1,995.26 | $2,238.72 | $6,025.60 |
Sutter Health Plus Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
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 $1,778.28 Median $2,454.71 Typical High $6,606.93 | Professional | None | $1,778.28 | $2,454.71 | $6,606.93 |
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 $954.99 Median $1,023.29 Typical High $1,230.27 | Professional | 52 · Reduced service | $954.99 | $1,023.29 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $407.38 Typical High $489.78 | Professional | 53 · Discontinued | $380.19 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,513.56 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,445.44 | $1,513.56 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $302.00 Typical High $371.54 | Professional | 55 · Aftercare only | $288.40 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $204.17 Typical High $245.47 | Professional | 56 · Pre-op care only | $190.55 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,412.54 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,412.54 | $1,698.24 |
Where California sits
The same service costs 5.2 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· 25th of 51
$2,754
AK $8,710TX $1,660
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.