How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $151,356Professionalmedian $1,288 · 10th to 90th $832 to $6,918
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 $1,000.00 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,000.00 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,318.26 | Professional | None | $891.25 | $954.99 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $9,549.93 Typical High $20,892.96 | Facility | None | $4,897.79 | $9,549.93 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $3,890.45 | Professional | None | $1,202.26 | $1,412.54 | $3,890.45 |
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 $758.58 Median $1,071.52 Typical High $2,137.96 | Professional | None | $758.58 | $1,071.52 | $2,137.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,174.90 | Professional | None | $741.31 | $1,047.13 | $1,174.90 |
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 $870.96 Median $1,071.52 Typical High $2,511.89 | Professional | None | $870.96 | $1,071.52 | $2,511.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $588.84 Median $1,047.13 Typical High $1,258.93 | Professional | None | $588.84 | $1,047.13 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $2,818.38 | Professional | None | $933.25 | $1,174.90 | $2,818.38 |
Lucent Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $8,511.38 | Professional | None | $6,918.31 | $6,918.31 | $8,511.38 |
Molina Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $831.76 Median $1,023.29 Typical High $2,630.27 | Professional | None | $831.76 | $1,023.29 | $2,630.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
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 $812.83 Median $1,174.90 Typical High $3,019.95 | Professional | None | $812.83 | $1,174.90 | $3,019.95 |
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 $446.68 Median $478.63 Typical High $562.34 | Professional | 52 · Reduced service | $446.68 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $223.87 | Professional | 53 · Discontinued | $177.83 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $831.76 | Professional | 54 · Surgery only | $660.69 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $165.96 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $112.20 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $776.25 |
Where California sits
The same service costs 4.7 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· 21st of 51
$1,479
AK $3,981TX $851
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.