How much rates vary
Facilitymedian $2,692 · 10th to 90th $794 to $10,233Professionalmedian $575 · 10th to 90th $479 to $4,467
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 $501.19 Median $524.81 Typical High $616.60 | Professional | None | $501.19 | $524.81 | $616.60 |
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 $512.86 Median $562.34 Typical High $954.99 | Professional | None | $512.86 | $562.34 | $954.99 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,995.26 Typical High $7,413.10 | Facility | None | $100.00 | $1,995.26 | $7,413.10 |
Blue Shield Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $645.65 | Professional | None | $363.08 | $524.81 | $645.65 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $776.25 | Professional | None | $524.81 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $4,365.16 | Facility | None | $645.65 | $2,238.72 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $954.99 | Professional | None | $489.78 | $575.44 | $954.99 |
Contra Costa Health Setting Professional Modifier None Typical Low $346.74 Median $691.83 Typical High $776.25 | Professional | None | $346.74 | $691.83 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $1,348.96 | Professional | None | $575.44 | $645.65 | $1,348.96 |
Lucent Health Setting Professional Modifier None Typical Low $4,466.84 Median $5,370.32 Typical High $5,370.32 | Professional | None | $4,466.84 | $5,370.32 | $5,370.32 |
Molina Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $676.08 Median $2,238.72 Typical High $5,248.07 | Facility | None | $676.08 | $2,238.72 | $5,248.07 |
Providence Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $912.01 | Professional | None | $489.78 | $575.44 | $912.01 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,090.30 | $10,964.78 |
United Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $977.24 | Professional | None | $467.74 | $575.44 | $977.24 |
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 $251.19 Median $263.03 Typical High $295.12 | Professional | 52 · Reduced service | $251.19 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $120.23 | Professional | 53 · Discontinued | $100.00 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $446.68 | Professional | 54 · Surgery only | $371.54 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $89.13 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $60.26 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $416.87 |
Where California sits
The same service costs 5.6 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· 44th of 51
$575
AK $2,512TX $447
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.