How much rates vary
Facilitymedian $2,188 · 10th to 90th $631 to $6,761Professionalmedian $204 · 10th to 90th $151 to $1,318
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 $154.88 Median $173.78 Typical High $251.19 | Professional | None | $154.88 | $173.78 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $2,137.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $676.08 | Professional | None | $199.53 | $218.78 | $676.08 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,862.09 Typical High $5,248.07 | Facility | None | $100.00 | $1,862.09 | $5,248.07 |
Blue Shield Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $457.09 | Professional | None | $131.83 | $186.21 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,995.26 Typical High $3,235.94 | Facility | None | $758.58 | $1,995.26 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $478.63 | Professional | None | $158.49 | $186.21 | $478.63 |
Contra Costa Health Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $245.47 | Professional | None | $181.97 | $199.53 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $467.74 | Professional | None | $162.18 | $204.17 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,318.26 | $1,318.26 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Providence Setting Facility Modifier None Typical Low $354.81 Median $1,905.46 Typical High $3,090.30 | Facility | None | $354.81 | $1,905.46 | $3,090.30 |
Providence Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $478.63 | Professional | None | $158.49 | $181.97 | $478.63 |
Sutter Health Plus Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $524.81 | Professional | None | $138.04 | $190.55 | $524.81 |
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 $74.13 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $74.13 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $30.20 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $125.89 Typical High $128.82 | Professional | 54 · Surgery only | $112.20 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.12 Typical High $25.70 | Professional | 55 · Aftercare only | $22.39 | $25.12 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.14 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $117.49 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $104.71 | $117.49 | $120.23 |
Where California sits
The same service costs 8.7 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· 31st of 51
$251
OK $1,349UT $155
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.