How much rates vary
Facilitymedian $3,236 · 10th to 90th $741 to $9,772Professionalmedian $501 · 10th to 90th $372 to $3,090
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 $426.58 Median $467.74 Typical High $1,905.46 | Professional | None | $426.58 | $467.74 | $1,905.46 |
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 $478.63 Median $512.86 Typical High $1,737.80 | Professional | None | $478.63 | $512.86 | $1,737.80 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,884.03 Typical High $7,413.10 | Facility | None | $100.00 | $2,884.03 | $7,413.10 |
Blue Shield Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $1,122.02 | Professional | None | $316.23 | $457.09 | $1,122.02 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $501.19 | Professional | None | $239.88 | $407.38 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,570.40 Typical High $5,248.07 | Facility | None | $562.34 | $2,570.40 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $1,174.90 | Professional | None | $398.11 | $467.74 | $1,174.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $190.55 Median $446.68 Typical High $537.03 | Professional | None | $190.55 | $446.68 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $1,023.29 | Professional | None | $407.38 | $501.19 | $1,023.29 |
Lucent Health Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,311.31 | Professional | None | $3,090.30 | $3,090.30 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $2,454.71 Typical High $5,754.40 | Facility | None | $537.03 | $2,454.71 | $5,754.40 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $1,174.90 | Professional | None | $398.11 | $457.09 | $1,174.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,365.16 | $14,454.40 |
United Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $1,258.93 | Professional | None | $331.13 | $489.78 | $1,258.93 |
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 $213.80 Median $229.09 Typical High $245.47 | Professional | 52 · Reduced service | $213.80 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $93.33 Typical High $97.72 | Professional | 53 · Discontinued | $85.11 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $346.74 Typical High $363.08 | Professional | 54 · Surgery only | $323.59 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $69.18 Typical High $72.44 | Professional | 55 · Aftercare only | $64.57 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $46.77 Typical High $48.98 | Professional | 56 · Pre-op care only | $42.66 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $323.59 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $302.00 | $323.59 | $338.84 |
Where California sits
The same service costs 8.9 times more in Oklahoma 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· 22nd of 51
$692
OK $2,951UT $331
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.