How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,047 to $12,589Professionalmedian $1,380 · 10th to 90th $912 to $7,762
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 $1,047.13 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,047.13 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,318.26 | Professional | None | $933.25 | $1,000.00 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,232.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $3,801.89 | Professional | None | $933.25 | $1,445.44 | $3,801.89 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $9,332.54 | Facility | None | $100.00 | $2,137.96 | $9,332.54 |
Blue Shield Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $2,398.83 | Professional | None | $870.96 | $1,230.27 | $2,398.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,000.00 | Professional | None | $812.83 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,511.89 Typical High $5,011.87 | Facility | None | $758.58 | $2,511.89 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $2,818.38 | Professional | None | $1,000.00 | $1,122.02 | $2,818.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,202.26 | Professional | None | $891.25 | $977.24 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $2,398.83 | Professional | None | $812.83 | $1,023.29 | $2,398.83 |
Lucent Health Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Professional | None | $7,762.47 | $7,762.47 | $7,762.47 |
Molina Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $2,398.83 Typical High $4,897.79 | Facility | None | $831.76 | $2,398.83 | $4,897.79 |
Providence Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,122.02 | $2,884.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,365.16 | $14,454.40 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $2,884.03 | Professional | None | $812.83 | $1,122.02 | $2,884.03 |
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 $467.74 Median $501.19 Typical High $549.54 | Professional | 52 · Reduced service | $467.74 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $218.78 | Professional | 53 · Discontinued | $186.21 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $758.58 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $109.65 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $707.95 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $707.95 | $758.58 |
Where California sits
The same service costs 4.6 times more in Wisconsin 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· 14th of 51
$1,820
WI $3,981TX $871
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.