How much rates vary
Facilitymedian $1,660 · 10th to 90th $525 to $6,607Professionalmedian $380 · 10th to 90th $275 to $2,570
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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $524.81 | Professional | None | $288.40 | $323.59 | $524.81 |
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 $316.23 Median $398.11 Typical High $1,230.27 | Professional | None | $316.23 | $398.11 | $1,230.27 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,862.09 Typical High $5,754.40 | Facility | None | $100.00 | $1,862.09 | $5,754.40 |
Blue Shield Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $776.25 | Professional | None | $213.80 | $309.03 | $776.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $512.86 | Professional | None | $309.03 | $426.58 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $2,570.40 Typical High $4,466.84 | Facility | None | $426.58 | $2,570.40 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $870.96 | Professional | None | $288.40 | $346.74 | $870.96 |
Contra Costa Health Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $457.09 | Professional | None | $302.00 | $380.19 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $1,023.29 | Professional | None | $331.13 | $416.87 | $1,023.29 |
Lucent Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,754.23 | Professional | None | $2,570.40 | $2,570.40 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Providence Setting Facility Modifier None Typical Low $398.11 Median $2,398.83 Typical High $4,466.84 | Facility | None | $398.11 | $2,398.83 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $933.25 | Professional | None | $288.40 | $331.13 | $933.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
United Setting Facility Modifier None Typical Low $524.81 Median $933.25 Typical High $5,495.41 | Facility | None | $524.81 | $933.25 | $5,495.41 |
United Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $1,047.13 | Professional | None | $257.04 | $363.08 | $1,047.13 |
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 $144.54 Median $158.49 Typical High $162.18 | Professional | 52 · Reduced service | $144.54 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $57.54 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $239.88 Typical High $245.47 | Professional | 54 · Surgery only | $213.80 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $47.86 Typical High $48.98 | Professional | 55 · Aftercare only | $42.66 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $31.62 Typical High $32.36 | Professional | 56 · Pre-op care only | $28.84 | $31.62 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $223.87 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $199.53 | $223.87 | $229.09 |
Where California sits
The same service costs 8.5 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· 27th of 51
$525
OK $2,138UT $251
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.