How much rates vary
Facilitymedian $5,012 · 10th to 90th $603 to $151,356Professionalmedian $2,344 · 10th to 90th $1,549 to $8,128
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 $1,778.28 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,778.28 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,698.24 | $2,344.23 |
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 $2,290.87 Median $2,691.53 Typical High $6,918.31 | Professional | None | $2,290.87 | $2,691.53 | $6,918.31 |
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 $1,445.44 Median $2,089.30 Typical High $4,073.80 | Professional | None | $1,445.44 | $2,089.30 | $4,073.80 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,621.81 | $1,995.26 | $2,951.21 |
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 $1,659.59 Median $1,995.26 Typical High $4,897.79 | Professional | None | $1,659.59 | $1,995.26 | $4,897.79 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,548.82 | $1,949.84 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $4,786.30 | Professional | None | $1,621.81 | $1,995.26 | $4,786.30 |
Lucent Health Setting Professional Modifier None Typical Low $23,442.29 Median $23,442.29 Typical High $23,442.29 | Professional | None | $23,442.29 | $23,442.29 | $23,442.29 |
Molina Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
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 $1,659.59 Median $1,905.46 Typical High $4,897.79 | Professional | None | $1,659.59 | $1,905.46 | $4,897.79 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | None | $5,623.41 | $5,623.41 | $5,623.41 |
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 $1,445.44 Median $1,995.26 Typical High $5,370.32 | Professional | None | $1,445.44 | $1,995.26 | $5,370.32 |
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 $794.33 Median $851.14 Typical High $1,000.00 | Professional | 52 · Reduced service | $794.33 | $851.14 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $338.84 Typical High $398.11 | Professional | 53 · Discontinued | $316.23 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,288.25 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,202.26 | $1,288.25 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $257.04 Typical High $302.00 | Professional | 55 · Aftercare only | $239.88 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $169.82 Typical High $199.53 | Professional | 56 · Pre-op care only | $158.49 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,202.26 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,202.26 | $1,412.54 |
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· 29th of 51
$2,399
AK $7,079TX $1,202
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.