How much rates vary
Facilitymedian $5,012 · 10th to 90th $603 to $151,356Professionalmedian $1,778 · 10th to 90th $1,175 to $6,310
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 $1,348.96 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,348.96 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,318.26 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $14,125.38 Typical High $25,118.86 | Facility | None | $7,244.36 | $14,125.38 | $25,118.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $5,248.07 | Professional | None | $1,621.81 | $1,949.84 | $5,248.07 |
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 $1,258.93 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,548.82 | $2,089.30 |
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 $1,230.27 Median $1,479.11 Typical High $3,467.37 | Professional | None | $1,230.27 | $1,479.11 | $3,467.37 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,380.38 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $3,715.35 | Professional | None | $1,258.93 | $1,584.89 | $3,715.35 |
Lucent Health Setting Professional Modifier None Typical Low $11,481.54 Median $11,481.54 Typical High $11,481.54 | Professional | None | $11,481.54 | $11,481.54 | $11,481.54 |
Molina Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $1,174.90 Median $1,445.44 Typical High $3,630.78 | Professional | None | $1,174.90 | $1,445.44 | $3,630.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
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 $1,122.02 Median $1,584.89 Typical High $4,168.69 | Professional | None | $1,122.02 | $1,584.89 | $4,168.69 |
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 $616.60 Median $660.69 Typical High $758.58 | Professional | 52 · Reduced service | $616.60 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $309.03 | Professional | 53 · Discontinued | $245.47 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $912.01 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $131.83 Typical High $154.88 | Professional | 56 · Pre-op care only | $123.03 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $912.01 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $851.14 | $912.01 | $1,071.52 |
Where California sits
The same service costs 9.0 times more in Alabama than in Maryland. 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.
Physician feeFacility fee
AL $18,720MD $2,076
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.