How much rates vary
Facilitymedian $5,012 · 10th to 90th $603 to $151,356Professionalmedian $2,570 · 10th to 90th $1,778 to $8,913
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 $1,949.84 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,949.84 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $2,511.89 | Professional | None | $1,778.28 | $1,949.84 | $2,511.89 |
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 $7,585.78 | Professional | None | $2,570.40 | $3,019.95 | $7,585.78 |
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 $1,584.89 Median $2,238.72 Typical High $4,365.16 | Professional | None | $1,584.89 | $2,238.72 | $4,365.16 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $3,467.37 | Professional | None | $1,778.28 | $2,089.30 | $3,467.37 |
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 $1,819.70 Median $2,187.76 Typical High $5,370.32 | Professional | None | $1,819.70 | $2,187.76 | $5,370.32 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,454.71 | Professional | None | $1,862.09 | $2,089.30 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,698.24 Median $2,187.76 Typical High $5,248.07 | Professional | None | $1,698.24 | $2,187.76 | $5,248.07 |
Lucent Health Setting Professional Modifier None Typical Low $22,908.68 Median $22,908.68 Typical High $22,908.68 | Professional | None | $22,908.68 | $22,908.68 | $22,908.68 |
Molina Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
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 $1,819.70 Median $2,089.30 Typical High $5,370.32 | Professional | None | $1,819.70 | $2,089.30 | $5,370.32 |
Sutter Health Plus Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Professional | None | $6,165.95 | $6,165.95 | $6,165.95 |
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 $1,621.81 Median $2,238.72 Typical High $5,888.44 | Professional | None | $1,621.81 | $2,238.72 | $5,888.44 |
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 $891.25 Median $954.99 Typical High $1,096.48 | Professional | 52 · Reduced service | $891.25 | $954.99 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $380.19 Typical High $446.68 | Professional | 53 · Discontinued | $354.81 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,412.54 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,348.96 | $1,412.54 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $281.84 Typical High $331.13 | Professional | 55 · Aftercare only | $269.15 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $190.55 Typical High $223.87 | Professional | 56 · Pre-op care only | $177.83 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,318.26 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,318.26 | $1,548.82 |
Where California sits
The same service costs 6.0 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
$2,630
AK $7,762TX $1,288
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.