How much rates vary
Facilitymedian $5,623 · 10th to 90th $617 to $151,356Professionalmedian $2,692 · 10th to 90th $1,738 to $9,333
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 $2,041.74 Median $8,128.31 Typical High $19,054.61 | Facility | None | $2,041.74 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,862.09 | $1,949.84 | $2,754.23 |
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 $2,570.40 Median $3,019.95 Typical High $7,762.47 | Professional | None | $2,570.40 | $3,019.95 | $7,762.47 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $5,888.44 Typical High $12,302.69 | Facility | None | $67.61 | $5,888.44 | $12,302.69 |
Blue Shield Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $3,715.35 | Professional | None | $1,258.93 | $1,819.70 | $3,715.35 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,187.76 Typical High $2,570.40 | Professional | None | $1,698.24 | $2,187.76 | $2,570.40 |
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 $1,905.46 Median $2,238.72 Typical High $5,623.41 | Professional | None | $1,905.46 | $2,238.72 | $5,623.41 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,949.84 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $5,248.07 | Professional | None | $1,737.80 | $2,238.72 | $5,248.07 |
Lucent Health Setting Professional Modifier None Typical Low $20,417.38 Median $20,417.38 Typical High $20,417.38 | Professional | None | $20,417.38 | $20,417.38 | $20,417.38 |
Molina Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
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 $1,905.46 Median $2,187.76 Typical High $5,623.41 | Professional | None | $1,905.46 | $2,187.76 | $5,623.41 |
Sutter Health Plus Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Professional | None | $6,456.54 | $6,456.54 | $6,456.54 |
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 $1,659.59 Median $2,290.87 Typical High $6,165.95 | Professional | None | $1,659.59 | $2,290.87 | $6,165.95 |
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 $933.25 Median $977.24 Typical High $1,148.15 | Professional | 52 · Reduced service | $933.25 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $398.11 Typical High $467.74 | Professional | 53 · Discontinued | $371.54 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,479.11 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,380.38 | $1,479.11 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $295.12 Typical High $346.74 | Professional | 55 · Aftercare only | $275.42 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $194.98 Typical High $229.09 | Professional | 56 · Pre-op care only | $186.21 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,380.38 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,380.38 | $1,621.81 |
Where California sits
The same service costs 5.4 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· 27th of 51
$2,692
AK $8,128TX $1,514
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.