How much rates vary
Facilitymedian $2,399 · 10th to 90th $537 to $6,607Professionalmedian $447 · 10th to 90th $347 to $3,311
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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $457.09 | Professional | None | $346.74 | $380.19 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $2,137.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $794.33 | Professional | None | $380.19 | $380.19 | $794.33 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $5,754.40 | Facility | None | $100.00 | $2,137.96 | $5,754.40 |
Blue Shield Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $562.34 | Professional | None | $302.00 | $436.52 | $562.34 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $660.69 | Professional | None | $512.86 | $616.60 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $2,187.76 Typical High $3,801.89 | Facility | None | $426.58 | $2,187.76 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $758.58 | Professional | None | $398.11 | $467.74 | $758.58 |
Contra Costa Health Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $616.60 | Professional | None | $371.54 | $549.54 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $1,000.00 | Professional | None | $436.52 | $501.19 | $1,000.00 |
Lucent Health Setting Professional Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,311.31 | $3,715.35 | $3,715.35 |
Molina Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $457.09 Median $2,089.30 Typical High $3,981.07 | Facility | None | $457.09 | $2,089.30 | $3,981.07 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $724.44 | Professional | None | $398.11 | $467.74 | $724.44 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $776.25 | Professional | None | $346.74 | $446.68 | $776.25 |
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 $173.78 Median $186.21 Typical High $223.87 | Professional | 52 · Reduced service | $173.78 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $75.86 Typical High $89.13 | Professional | 53 · Discontinued | $69.18 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $281.84 Typical High $338.84 | Professional | 54 · Surgery only | $263.03 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $56.23 Typical High $67.61 | Professional | 55 · Aftercare only | $52.48 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.02 Typical High $44.67 | Professional | 56 · Pre-op care only | $34.67 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $263.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $245.47 | $263.03 | $316.23 |
Where California sits
The same service costs 6.2 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· 39th of 51
$457
AK $1,862TX $302
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.