How much rates vary
Facilitymedian $5,129 · 10th to 90th $603 to $151,356Professionalmedian $3,631 · 10th to 90th $2,344 to $12,303
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 $2,691.53 Median $8,128.31 Typical High $19,054.61 | Facility | None | $2,691.53 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,630.27 Typical High $3,548.13 | Professional | None | $2,454.71 | $2,630.27 | $3,548.13 |
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 $3,630.78 Median $4,168.69 Typical High $10,471.29 | Professional | None | $3,630.78 | $4,168.69 | $10,471.29 |
Blue Shield Setting Facility Modifier None Typical Low $48.98 Median $79.43 Typical High $100.00 | Facility | None | $48.98 | $79.43 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $1,819.70 Median $2,630.27 Typical High $5,248.07 | Professional | None | $1,819.70 | $2,630.27 | $5,248.07 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $5,128.61 | Professional | None | $2,511.89 | $3,019.95 | $5,128.61 |
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 $2,511.89 Median $2,951.21 Typical High $7,413.10 | Professional | None | $2,511.89 | $2,951.21 | $7,413.10 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,951.21 Typical High $3,467.37 | Professional | None | $2,691.53 | $2,951.21 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $3,019.95 Typical High $7,244.36 | Professional | None | $2,290.87 | $3,019.95 | $7,244.36 |
Lucent Health Setting Professional Modifier None Typical Low $25,703.96 Median $25,703.96 Typical High $25,703.96 | Professional | None | $25,703.96 | $25,703.96 | $25,703.96 |
Molina Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
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 $2,511.89 Median $2,884.03 Typical High $7,585.78 | Professional | None | $2,511.89 | $2,884.03 | $7,585.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | None | $8,511.38 | $8,511.38 | $8,511.38 |
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 $2,187.76 Median $3,019.95 Typical High $8,128.31 | Professional | None | $2,187.76 | $3,019.95 | $8,128.31 |
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 $1,230.27 Median $1,318.26 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,230.27 | $1,318.26 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $524.81 Typical High $602.56 | Professional | 53 · Discontinued | $489.78 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,995.26 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,862.09 | $1,995.26 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $398.11 Typical High $457.09 | Professional | 55 · Aftercare only | $371.54 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $263.03 Typical High $302.00 | Professional | 56 · Pre-op care only | $245.47 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,862.09 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,862.09 | $2,137.96 |
Where California sits
The same service costs 6.9 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· 24th of 51
$3,631
AK $10,715TX $1,549
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.