How much rates vary
Facilitymedian $3,236 · 10th to 90th $603 to $151,356Professionalmedian $1,698 · 10th to 90th $977 to $7,413
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 $2,238.72 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,238.72 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,479.11 | Professional | None | $977.24 | $1,071.52 | $1,479.11 |
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 $1,412.54 Median $1,905.46 Typical High $4,265.80 | Professional | None | $1,412.54 | $1,905.46 | $4,265.80 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $954.99 Typical High $2,041.74 | Facility | None | $67.61 | $954.99 | $2,041.74 |
Blue Shield Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $2,238.72 | Professional | None | $794.33 | $1,148.15 | $2,238.72 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,621.81 | Professional | None | $912.01 | $1,122.02 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $10,000.00 | Facility | None | $660.69 | $1,258.93 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $3,235.94 | Professional | None | $1,047.13 | $1,288.25 | $3,235.94 |
Contra Costa Health Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,318.26 | Professional | None | $954.99 | $1,096.48 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $2,691.53 | Professional | None | $912.01 | $1,148.15 | $2,691.53 |
Lucent Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $8,511.38 | Professional | None | $7,413.10 | $7,413.10 | $8,511.38 |
Molina Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $812.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $3,235.94 | Professional | None | $1,047.13 | $1,258.93 | $3,235.94 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 $912.01 Median $1,258.93 Typical High $3,235.94 | Professional | None | $912.01 | $1,258.93 | $3,235.94 |
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 $512.86 Median $537.03 Typical High $602.56 | Professional | 52 · Reduced service | $512.86 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $213.80 Typical High $245.47 | Professional | 53 · Discontinued | $204.17 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $794.33 Typical High $933.25 | Professional | 54 · Surgery only | $741.31 | $794.33 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $158.49 Typical High $181.97 | Professional | 55 · Aftercare only | $154.88 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $107.15 Typical High $123.03 | Professional | 56 · Pre-op care only | $102.33 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $741.31 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $707.95 | $741.31 | $851.14 |
Where California sits
The same service costs 7.5 times more in Colorado than in Maryland. 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
CO $13,030MD $1,737
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.