How much rates vary
Facilitymedian $5,129 · 10th to 90th $617 to $151,356Professionalmedian $2,089 · 10th to 90th $1,445 to $20,417
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 $1,584.89 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,584.89 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,513.56 | $2,290.87 |
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 $2,041.74 Median $2,398.83 Typical High $6,165.95 | Professional | None | $2,041.74 | $2,398.83 | $6,165.95 |
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 $1,318.26 Median $1,862.09 Typical High $3,630.78 | Professional | None | $1,318.26 | $1,862.09 | $3,630.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $3,162.28 | Professional | None | $1,479.11 | $1,778.28 | $3,162.28 |
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 $1,479.11 Median $1,778.28 Typical High $4,365.16 | Professional | None | $1,479.11 | $1,778.28 | $4,365.16 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,584.89 | $1,778.28 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $4,265.80 | Professional | None | $1,445.44 | $1,819.70 | $4,265.80 |
Lucent Health Setting Professional Modifier None Typical Low $20,417.38 Median $21,877.62 Typical High $21,877.62 | Professional | None | $20,417.38 | $21,877.62 | $21,877.62 |
Molina Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
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 $1,445.44 Median $1,698.24 Typical High $4,365.16 | Professional | None | $1,445.44 | $1,698.24 | $4,365.16 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
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 $1,288.25 Median $1,819.70 Typical High $4,786.30 | Professional | None | $1,288.25 | $1,819.70 | $4,786.30 |
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 $707.95 Median $758.58 Typical High $891.25 | Professional | 52 · Reduced service | $707.95 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $302.00 Typical High $354.81 | Professional | 53 · Discontinued | $281.84 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,148.15 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,071.52 | $1,148.15 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $229.09 Typical High $263.03 | Professional | 55 · Aftercare only | $213.80 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $151.36 Typical High $177.83 | Professional | 56 · Pre-op care only | $141.25 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,071.52 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,071.52 | $1,230.27 |
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· 22nd of 51
$2,291
AK $6,310TX $1,148
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.