How much rates vary
Facilitymedian $5,129 · 10th to 90th $955 to $14,454Professionalmedian $912 · 10th to 90th $589 to $4,786
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 $1,778.28 Median $6,760.83 Typical High $16,218.10 | Facility | None | $1,778.28 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $954.99 | Professional | None | $588.84 | $707.95 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,511.38 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $2,630.27 | Professional | None | $870.96 | $1,023.29 | $2,630.27 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $14,125.38 | Facility | None | $100.00 | $2,137.96 | $14,125.38 |
Blue Shield Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,584.89 | Professional | None | $575.44 | $812.83 | $1,584.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $776.25 | Professional | None | $512.86 | $724.44 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,897.79 Typical High $8,709.64 | Facility | None | $707.95 | $4,897.79 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,905.46 | Professional | None | $645.65 | $776.25 | $1,905.46 |
Contra Costa Health Setting Professional Modifier None Typical Low $407.38 Median $660.69 Typical High $794.33 | Professional | None | $407.38 | $660.69 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,778.28 | Professional | None | $588.84 | $758.58 | $1,778.28 |
Lucent Health Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,495.41 | Professional | None | $4,786.30 | $4,786.30 | $5,495.41 |
Molina Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $724.44 Median $4,786.30 Typical High $8,709.64 | Facility | None | $724.44 | $4,786.30 | $8,709.64 |
Providence Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $1,905.46 | Professional | None | $645.65 | $741.31 | $1,905.46 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $19,054.61 | Facility | None | $2,884.03 | $6,760.83 | $19,054.61 |
United Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $2,089.30 | Professional | None | $575.44 | $758.58 | $2,089.30 |
4 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 54 · Surgery only Typical Low $457.09 Median $489.78 Typical High $588.84 | Professional | 54 · Surgery only | $457.09 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $97.72 Typical High $117.49 | Professional | 55 · Aftercare only | $91.20 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $66.07 Typical High $77.62 | Professional | 56 · Pre-op care only | $61.66 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $457.09 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $426.58 | $457.09 | $549.54 |
Where California sits
The same service costs 5.1 times more in Wisconsin than in Montana. 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.
Physician feeFacility fee
WI $10,473MT $2,074
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.