How much rates vary
Facilitymedian $2,291 · 10th to 90th $832 to $8,318Professionalmedian $355 · 10th to 90th $288 to $1,202
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 $1,905.46 Median $6,165.95 Typical High $15,848.93 | Facility | None | $1,905.46 | $6,165.95 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $371.54 | Professional | None | $309.03 | $331.13 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $354.81 Typical High $602.56 | Professional | None | $331.13 | $354.81 | $602.56 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,570.40 Typical High $6,760.83 | Facility | None | $100.00 | $2,570.40 | $6,760.83 |
Blue Shield Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $407.38 | Professional | None | $229.09 | $323.59 | $407.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $602.56 | Professional | None | $436.52 | $478.63 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,187.76 Typical High $4,365.16 | Facility | None | $562.34 | $2,187.76 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $575.44 | Professional | None | $309.03 | $371.54 | $575.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $467.74 | Professional | None | $346.74 | $426.58 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $831.76 | Professional | None | $354.81 | $407.38 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Professional | None | $4,168.69 | $4,168.69 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $478.63 Median $2,187.76 Typical High $4,786.30 | Facility | None | $478.63 | $2,187.76 | $4,786.30 |
Providence Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $575.44 | Professional | None | $302.00 | $371.54 | $575.44 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
United Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $7,585.78 | Facility | None | $831.76 | $933.25 | $7,585.78 |
United Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $588.84 | Professional | None | $288.40 | $346.74 | $588.84 |
7 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 $154.88 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $154.88 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $66.07 Typical High $74.13 | Professional | 53 · Discontinued | $61.66 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $245.47 Typical High $281.84 | Professional | 54 · Surgery only | $234.42 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $48.98 Typical High $56.23 | Professional | 55 · Aftercare only | $46.77 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $30.90 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $229.09 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $218.78 | $229.09 | $263.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $190.55 Median $234.42 Typical High $426.58 | Professional | 62 · Two surgeons | $190.55 | $234.42 | $426.58 |
Where California sits
The same service costs 5.1 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· 45th of 51
$363
AK $1,549UT $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.