How much rates vary
Facilitymedian $5,370 · 10th to 90th $631 to $50,119Professionalmedian $2,042 · 10th to 90th $1,380 to $10,715
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 $1,548.82 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,548.82 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,479.11 | $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 $1,949.84 Median $2,238.72 Typical High $6,025.60 | Professional | None | $1,949.84 | $2,238.72 | $6,025.60 |
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 $1,258.93 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,258.93 | $1,819.70 | $3,467.37 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,737.80 | $2,290.87 |
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 $1,445.44 Median $1,737.80 Typical High $4,265.80 | Professional | None | $1,445.44 | $1,737.80 | $4,265.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,548.82 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $4,168.69 | Professional | None | $1,380.38 | $1,737.80 | $4,168.69 |
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 $1,445.44 Median $1,659.59 Typical High $4,265.80 | Professional | None | $1,445.44 | $1,659.59 | $4,265.80 |
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 $1,258.93 Median $1,737.80 Typical High $4,677.35 | Professional | None | $1,258.93 | $1,737.80 | $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 $741.31 Typical High $870.96 | Professional | 52 · Reduced service | $691.83 | $741.31 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $295.12 Typical High $346.74 | Professional | 53 · Discontinued | $281.84 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,122.02 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,047.13 | $1,122.02 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $223.87 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $147.91 Typical High $173.78 | Professional | 56 · Pre-op care only | $138.04 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,047.13 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $977.24 | $1,047.13 | $1,202.26 |
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· 20th of 51
$2,291
AK $6,166TX $1,096
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.