How much rates vary
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 $1,412.54 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,412.54 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,380.38 | $1,905.46 |
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 $1,548.82 Median $2,041.74 Typical High $5,623.41 | Professional | None | $1,548.82 | $2,041.74 | $5,623.41 |
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 $1,096.48 Median $1,548.82 Typical High $3,019.95 | Professional | None | $1,096.48 | $1,548.82 | $3,019.95 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,659.59 | $2,398.83 |
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 $1,348.96 Median $1,584.89 Typical High $3,981.07 | Professional | None | $1,348.96 | $1,584.89 | $3,981.07 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,584.89 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $3,981.07 | Professional | None | $1,318.26 | $1,659.59 | $3,981.07 |
Lucent Health Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $12,022.64 | Professional | None | $10,000.00 | $10,000.00 | $12,022.64 |
Molina Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $1,348.96 Median $1,548.82 Typical High $3,981.07 | Professional | None | $1,348.96 | $1,548.82 | $3,981.07 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
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 $1,174.90 Median $1,659.59 Typical High $4,365.16 | Professional | None | $1,174.90 | $1,659.59 | $4,365.16 |
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 $645.65 Median $676.08 Typical High $812.83 | Professional | 52 · Reduced service | $645.65 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $275.42 Typical High $323.59 | Professional | 53 · Discontinued | $257.04 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,023.29 Typical High $1,202.26 | Professional | 54 · Surgery only | $954.99 | $1,023.29 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $204.17 Typical High $239.88 | Professional | 55 · Aftercare only | $190.55 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $138.04 Typical High $162.18 | Professional | 56 · Pre-op care only | $128.82 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $954.99 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $891.25 | $954.99 | $1,122.02 |
Where California sits
The same service costs 5.6 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· 24th of 51
$2,042
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.