How much rates vary
Facilitymedian $4,467 · 10th to 90th $617 to $151,356Professionalmedian $1,660 · 10th to 90th $1,122 to $8,710
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 $1,737.80 | Professional | None | $1,096.48 | $1,174.90 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $13,182.57 Typical High $23,442.29 | Facility | None | $6,760.83 | $13,182.57 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $4,897.79 | Professional | None | $1,621.81 | $1,905.46 | $4,897.79 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,606.93 | Facility | None | $67.61 | $3,090.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $2,691.53 | Professional | None | $954.99 | $1,380.38 | $2,691.53 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,445.44 | $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 $1,174.90 Median $1,380.38 Typical High $3,388.44 | Professional | None | $1,174.90 | $1,380.38 | $3,388.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,412.54 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $3,467.37 | Professional | None | $1,174.90 | $1,479.11 | $3,467.37 |
Lucent Health Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $10,471.29 | Professional | None | $8,709.64 | $8,709.64 | $10,471.29 |
Molina Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $1,348.96 Typical High $3,388.44 | Professional | None | $1,174.90 | $1,348.96 | $3,388.44 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
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 $1,023.29 Median $1,479.11 Typical High $3,801.89 | Professional | None | $1,023.29 | $1,479.11 | $3,801.89 |
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 $549.54 Median $575.44 Typical High $707.95 | Professional | 52 · Reduced service | $549.54 | $575.44 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $234.42 Typical High $281.84 | Professional | 53 · Discontinued | $218.78 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $1,071.52 | Professional | 54 · Surgery only | $812.83 | $870.96 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $213.80 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $117.49 Typical High $141.25 | Professional | 56 · Pre-op care only | $109.65 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $1,000.00 |
Where California sits
The same service costs 4.8 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· 19th of 51
$1,862
AK $5,012TX $1,047
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.