How much rates vary
Facilitymedian $5,012 · 10th to 90th $603 to $151,356Professionalmedian $1,698 · 10th to 90th $1,202 to $7,244
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 $1,202.26 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,202.26 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,174.90 | $2,089.30 |
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 $1,584.89 Median $1,949.84 Typical High $5,888.44 | Professional | None | $1,584.89 | $1,949.84 | $5,888.44 |
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 $1,000.00 Median $1,445.44 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,445.44 | $2,884.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,659.59 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,348.96 Typical High $10,000.00 | Facility | None | $660.69 | $1,348.96 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $4,265.80 | Professional | None | $1,258.93 | $1,659.59 | $4,265.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,621.81 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $3,981.07 | Professional | None | $1,348.96 | $1,698.24 | $3,981.07 |
Lucent Health Setting Professional Modifier None Typical Low $19,498.45 Median $19,498.45 Typical High $19,498.45 | Professional | None | $19,498.45 | $19,498.45 | $19,498.45 |
Molina Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $812.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $4,365.16 | Professional | None | $1,258.93 | $1,621.81 | $4,365.16 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
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 $1,230.27 Median $1,698.24 Typical High $4,677.35 | Professional | None | $1,230.27 | $1,698.24 | $4,677.35 |
5 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 $549.54 Median $588.84 Typical High $870.96 | Professional | 52 · Reduced service | $549.54 | $588.84 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $234.42 Typical High $346.74 | Professional | 53 · Discontinued | $218.78 | $234.42 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $1,318.26 | Professional | 54 · Surgery only | $812.83 | $870.96 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $263.03 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $117.49 Typical High $173.78 | Professional | 56 · Pre-op care only | $109.65 | $117.49 | $173.78 |
Where California sits
The same service costs 4.7 times more in Alaska than in Delaware. 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· 35th of 51
$1,862
AK $6,166DE $1,318
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.