How much rates vary
Facilitymedian $5,495 · 10th to 90th $617 to $151,356Professionalmedian $1,905 · 10th to 90th $1,318 to $6,761
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 $1,445.44 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,445.44 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,412.54 | $1,949.84 |
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 $1,905.46 Median $2,238.72 Typical High $5,754.40 | Professional | None | $1,905.46 | $2,238.72 | $5,754.40 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $4,786.30 Typical High $10,000.00 | Facility | None | $67.61 | $4,786.30 | $10,000.00 |
Blue Shield Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $3,311.31 | Professional | None | $1,202.26 | $1,698.24 | $3,311.31 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $3,548.13 | Professional | None | $1,380.38 | $1,862.09 | $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 $1,380.38 Median $1,659.59 Typical High $4,073.80 | Professional | None | $1,380.38 | $1,659.59 | $4,073.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,513.56 | $1,862.09 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $3,981.07 | Professional | None | $1,348.96 | $1,698.24 | $3,981.07 |
Lucent Health Setting Professional Modifier None Typical Low $18,620.87 Median $18,620.87 Typical High $18,620.87 | Professional | None | $18,620.87 | $18,620.87 | $18,620.87 |
Molina Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $1,348.96 Median $1,584.89 Typical High $4,073.80 | Professional | None | $1,348.96 | $1,584.89 | $4,073.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
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 $1,202.26 Median $1,698.24 Typical High $4,466.84 | Professional | None | $1,202.26 | $1,698.24 | $4,466.84 |
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 $660.69 Median $707.95 Typical High $831.76 | Professional | 52 · Reduced service | $660.69 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $281.84 Typical High $331.13 | Professional | 53 · Discontinued | $263.03 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,047.13 Typical High $1,230.27 | Professional | 54 · Surgery only | $977.24 | $1,047.13 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $208.93 Typical High $245.47 | Professional | 55 · Aftercare only | $194.98 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $141.25 Typical High $165.96 | Professional | 56 · Pre-op care only | $131.83 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $977.24 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $912.01 | $977.24 | $1,148.15 |
Where California sits
The same service costs 5.9 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· 26th of 51
$2,089
AK $5,888TX $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.