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 $1,513.56 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,513.56 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,445.44 | $2,089.30 |
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 $1,548.82 Median $2,238.72 Typical High $6,025.60 | Professional | None | $1,548.82 | $2,238.72 | $6,025.60 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $4,168.69 Typical High $8,709.64 | Facility | None | $67.61 | $4,168.69 | $8,709.64 |
Blue Shield Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $3,467.37 | Professional | None | $1,258.93 | $1,778.28 | $3,467.37 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,778.28 | $2,691.53 |
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 $1,479.11 Median $1,737.80 Typical High $4,365.16 | Professional | None | $1,479.11 | $1,737.80 | $4,365.16 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,737.80 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $4,265.80 | Professional | None | $1,348.96 | $1,778.28 | $4,265.80 |
Lucent Health Setting Professional Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $12,882.50 | Professional | None | $10,715.19 | $10,715.19 | $12,882.50 |
Molina Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
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 $1,479.11 Median $1,698.24 Typical High $4,365.16 | Professional | None | $1,479.11 | $1,698.24 | $4,365.16 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
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 $1,288.25 Median $1,778.28 Typical High $4,677.35 | Professional | None | $1,288.25 | $1,778.28 | $4,677.35 |
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 $691.83 Median $724.44 Typical High $870.96 | Professional | 52 · Reduced service | $691.83 | $724.44 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $295.12 Typical High $354.81 | Professional | 53 · Discontinued | $275.42 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,096.48 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,023.29 | $1,096.48 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $218.78 Typical High $263.03 | Professional | 55 · Aftercare only | $204.17 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $144.54 Typical High $177.83 | Professional | 56 · Pre-op care only | $138.04 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,023.29 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $954.99 | $1,023.29 | $1,230.27 |
Where California sits
The same service costs 5.2 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· 22nd of 51
$2,291
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.