How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,318 to $15,136Professionalmedian $1,318 · 10th to 90th $977 to $8,913
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 $2,398.83 Median $9,120.11 Typical High $21,379.62 | Facility | None | $2,398.83 | $9,120.11 | $21,379.62 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,122.02 | $1,698.24 |
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 $1,318.26 Median $1,380.38 Typical High $4,570.88 | Professional | None | $1,318.26 | $1,380.38 | $4,570.88 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,290.87 Typical High $14,125.38 | Facility | None | $100.00 | $2,290.87 | $14,125.38 |
Blue Shield Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $1,819.70 | Professional | None | $870.96 | $1,258.93 | $1,819.70 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,380.38 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $4,570.88 Typical High $9,120.11 | Facility | None | $1,148.15 | $4,570.88 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,995.26 | Professional | None | $977.24 | $1,174.90 | $1,995.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $1,479.11 | Professional | None | $851.14 | $1,258.93 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $3,388.44 | Professional | None | $1,023.29 | $1,230.27 | $3,388.44 |
Lucent Health Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $9,120.11 | Professional | None | $8,912.51 | $8,912.51 | $9,120.11 |
Molina Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Providence Setting Facility Modifier None Typical Low $1,122.02 Median $4,677.35 Typical High $10,232.93 | Facility | None | $1,122.02 | $4,677.35 | $10,232.93 |
Providence Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,949.84 | Professional | None | $977.24 | $1,174.90 | $1,949.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,754.40 | $17,378.01 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $2,290.87 | Professional | None | $912.01 | $1,148.15 | $2,290.87 |
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 $501.19 Median $524.81 Typical High $602.56 | Professional | 52 · Reduced service | $501.19 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $208.93 Typical High $239.88 | Professional | 53 · Discontinued | $199.53 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $794.33 Typical High $912.01 | Professional | 54 · Surgery only | $741.31 | $794.33 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $158.49 Typical High $181.97 | Professional | 55 · Aftercare only | $147.91 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $104.71 Typical High $120.23 | Professional | 56 · Pre-op care only | $100.00 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $741.31 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $691.83 | $741.31 | $851.14 |
Where California sits
The same service costs 5.5 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· 34th of 51
$1,479
AK $4,786TX $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.