How much rates vary
Facilitymedian $2,239 · 10th to 90th $813 to $10,233Professionalmedian $257 · 10th to 90th $209 to $1,820
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 $1,949.84 Median $7,413.10 Typical High $18,197.01 | Facility | None | $1,949.84 | $7,413.10 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $371.54 | Professional | None | $213.80 | $257.04 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $8,128.31 Typical High $16,982.44 | Facility | None | $3,890.45 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $245.47 Typical High $436.52 | Professional | None | $239.88 | $245.47 | $436.52 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,862.09 Typical High $8,709.64 | Facility | None | $100.00 | $1,862.09 | $8,709.64 |
Blue Shield Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $323.59 | Professional | None | $181.97 | $263.03 | $323.59 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $295.12 | Professional | None | $177.83 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,290.87 Typical High $4,570.88 | Facility | None | $758.58 | $2,290.87 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $380.19 | Professional | None | $229.09 | $251.19 | $380.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $117.49 Median $263.03 Typical High $295.12 | Professional | None | $117.49 | $263.03 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $524.81 | Professional | None | $218.78 | $245.47 | $524.81 |
Lucent Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,819.70 | $1,905.46 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $630.96 Median $2,344.23 Typical High $6,165.95 | Facility | None | $630.96 | $2,344.23 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $380.19 | Professional | None | $229.09 | $245.47 | $380.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
United Setting Facility Modifier None Typical Low $812.83 Median $933.25 Typical High $7,585.78 | Facility | None | $812.83 | $933.25 | $7,585.78 |
United Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $389.05 | Professional | None | $186.21 | $239.88 | $389.05 |
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 $109.65 Median $117.49 Typical High $138.04 | Professional | 52 · Reduced service | $109.65 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $44.67 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $177.83 Typical High $204.17 | Professional | 54 · Surgery only | $165.96 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $35.48 Typical High $40.74 | Professional | 55 · Aftercare only | $33.11 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $23.44 Typical High $27.54 | Professional | 56 · Pre-op care only | $21.88 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $165.96 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $154.88 | $165.96 | $190.55 |
Where California sits
The same service costs 6.0 times more in Alaska than in Utah. 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
$263
AK $1,000UT $166
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.