How much rates vary
Facilitymedian $3,020 · 10th to 90th $813 to $10,233Professionalmedian $324 · 10th to 90th $229 to $1,905
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 $269.15 Median $288.40 Typical High $2,398.83 | Professional | None | $269.15 | $288.40 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,606.93 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $1,071.52 | Professional | None | $309.03 | $331.13 | $1,071.52 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,862.09 Typical High $9,332.54 | Facility | None | $100.00 | $1,862.09 | $9,332.54 |
Blue Shield Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $741.31 | Professional | None | $218.78 | $316.23 | $741.31 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $331.13 | Professional | None | $218.78 | $275.42 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,630.27 Typical High $5,011.87 | Facility | None | $691.83 | $2,630.27 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $724.44 | Professional | None | $251.19 | $295.12 | $724.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $302.00 | Professional | None | $173.78 | $251.19 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $616.60 | Professional | None | $223.87 | $281.84 | $616.60 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,905.46 | $1,905.46 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,691.53 Typical High $5,754.40 | Facility | None | $602.56 | $2,691.53 | $5,754.40 |
Providence Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $724.44 | Professional | None | $251.19 | $281.84 | $724.44 |
Sutter Health Plus Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
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 $208.93 Median $288.40 Typical High $776.25 | Professional | None | $208.93 | $288.40 | $776.25 |
3 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 54 · Surgery only Typical Low $199.53 Median $213.80 Typical High $223.87 | Professional | 54 · Surgery only | $199.53 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $42.66 Typical High $44.67 | Professional | 55 · Aftercare only | $39.81 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.84 Typical High $29.51 | Professional | 56 · Pre-op care only | $26.30 | $28.84 | $29.51 |
Where California sits
The same service costs 7.2 times more in Oklahoma than in New York. 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· 23rd of 51
$457
OK $1,950NY $269
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.