How much rates vary
Facilitymedian $5,012 · 10th to 90th $603 to $151,356Professionalmedian $2,818 · 10th to 90th $1,862 to $9,550
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 $2,089.30 Median $8,128.31 Typical High $19,054.61 | Facility | None | $2,089.30 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $2,951.21 | Professional | None | $1,905.46 | $2,041.74 | $2,951.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $15,848.93 Typical High $29,512.09 | Facility | None | $7,585.78 | $15,848.93 | $29,512.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,818.38 Median $3,311.31 Typical High $8,128.31 | Professional | None | $2,818.38 | $3,311.31 | $8,128.31 |
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 $1,698.24 Median $2,454.71 Typical High $4,786.30 | Professional | None | $1,698.24 | $2,454.71 | $4,786.30 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $3,235.94 | Professional | None | $1,862.09 | $2,290.87 | $3,235.94 |
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 $1,949.84 Median $2,344.23 Typical High $5,888.44 | Professional | None | $1,949.84 | $2,344.23 | $5,888.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $2,570.40 | Professional | None | $1,698.24 | $2,137.96 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $5,495.41 | Professional | None | $1,778.28 | $2,344.23 | $5,495.41 |
Lucent Health Setting Professional Modifier None Typical Low $23,988.33 Median $23,988.33 Typical High $23,988.33 | Professional | None | $23,988.33 | $23,988.33 | $23,988.33 |
Molina Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
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 $1,949.84 Median $2,290.87 Typical High $5,888.44 | Professional | None | $1,949.84 | $2,290.87 | $5,888.44 |
Sutter Health Plus Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Professional | None | $6,760.83 | $6,760.83 | $6,760.83 |
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 $1,778.28 Median $2,398.83 Typical High $6,309.57 | Professional | None | $1,778.28 | $2,398.83 | $6,309.57 |
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 $954.99 Median $1,023.29 Typical High $1,202.26 | Professional | 52 · Reduced service | $954.99 | $1,023.29 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $407.38 Typical High $478.63 | Professional | 53 · Discontinued | $380.19 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,513.56 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,412.54 | $1,513.56 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $302.00 Typical High $354.81 | Professional | 55 · Aftercare only | $281.84 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $204.17 Typical High $239.88 | Professional | 56 · Pre-op care only | $190.55 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,412.54 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,412.54 | $1,659.59 |
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· 28th of 51
$2,818
AK $8,318TX $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.