How much rates vary
Facilitymedian $4,266 · 10th to 90th $955 to $11,220Professionalmedian $955 · 10th to 90th $724 to $3,981
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 $831.76 Median $870.96 Typical High $1,023.29 | Professional | None | $831.76 | $870.96 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,511.38 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $3,388.44 | Professional | None | $933.25 | $1,023.29 | $3,388.44 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,884.03 Typical High $8,128.31 | Facility | None | $100.00 | $2,884.03 | $8,128.31 |
Blue Shield Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $2,238.72 | Professional | None | $645.65 | $912.01 | $2,238.72 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,412.54 | Professional | None | $776.25 | $954.99 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,981.07 Typical High $6,918.31 | Facility | None | $645.65 | $3,981.07 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $2,344.23 | Professional | None | $794.33 | $912.01 | $2,344.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,122.02 | Professional | None | $741.31 | $933.25 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,905.46 | Professional | None | $758.58 | $954.99 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Professional | None | $8,128.31 | $8,128.31 | $8,128.31 |
Molina 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 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $3,801.89 Typical High $7,079.46 | Facility | None | $758.58 | $3,801.89 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $2,344.23 | Professional | None | $794.33 | $870.96 | $2,344.23 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
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 $660.69 Median $954.99 Typical High $2,454.71 | Professional | None | $660.69 | $954.99 | $2,454.71 |
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 $416.87 Median $436.52 Typical High $457.09 | Professional | 52 · Reduced service | $416.87 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $177.83 Typical High $181.97 | Professional | 53 · Discontinued | $165.96 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $660.69 Typical High $691.83 | Professional | 54 · Surgery only | $630.96 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $138.04 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $87.10 Typical High $91.20 | Professional | 56 · Pre-op care only | $83.18 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $616.60 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $588.84 | $616.60 | $645.65 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $512.86 Typical High $1,230.27 | Professional | 62 · Two surgeons | $389.05 | $512.86 | $1,230.27 |
Where California sits
The same service costs 5.9 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· 31st of 51
$1,175
AK $3,467TX $589
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.