How much rates vary
Facilitymedian $4,898 · 10th to 90th $603 to $151,356Professionalmedian $1,698 · 10th to 90th $1,122 to $6,026
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 $1,288.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,288.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,258.93 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $13,489.63 Typical High $23,442.29 | Facility | None | $6,918.31 | $13,489.63 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $5,128.61 | Professional | None | $1,659.59 | $1,949.84 | $5,128.61 |
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 $977.24 Median $1,380.38 Typical High $2,754.23 | Professional | None | $977.24 | $1,380.38 | $2,754.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,513.56 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $10,000.00 | Facility | None | $660.69 | $1,412.54 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $3,548.13 | Professional | None | $1,202.26 | $1,412.54 | $3,548.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,479.11 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $3,630.78 | Professional | None | $1,202.26 | $1,513.56 | $3,630.78 |
Lucent Health Setting Professional Modifier None Typical Low $12,882.50 Median $12,882.50 Typical High $12,882.50 | Professional | None | $12,882.50 | $12,882.50 | $12,882.50 |
Molina Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $1,202.26 Median $1,380.38 Typical High $3,548.13 | Professional | None | $1,202.26 | $1,380.38 | $3,548.13 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
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 $1,071.52 Median $1,513.56 Typical High $3,981.07 | Professional | None | $1,071.52 | $1,513.56 | $3,981.07 |
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 $575.44 Median $616.60 Typical High $724.44 | Professional | 52 · Reduced service | $575.44 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $251.19 Typical High $288.40 | Professional | 53 · Discontinued | $234.42 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $933.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $870.96 | $933.25 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $125.89 Typical High $144.54 | Professional | 56 · Pre-op care only | $117.49 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $870.96 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $812.83 | $870.96 | $1,023.29 |
Where California sits
The same service costs 4.9 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· 28th of 51
$1,778
AK $5,248TX $1,072
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.