How much rates vary
Facilitymedian $3,981 · 10th to 90th $631 to $50,119Professionalmedian $1,230 · 10th to 90th $832 to $6,918
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 $933.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,071.52 | Professional | None | $812.83 | $933.25 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $6,918.31 Typical High $17,378.01 | Facility | None | $2,511.89 | $6,918.31 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,318.26 Typical High $3,715.35 | Professional | None | $831.76 | $1,318.26 | $3,715.35 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,606.93 | Facility | None | $67.61 | $3,090.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $2,454.71 | Professional | None | $691.83 | $1,000.00 | $2,454.71 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $478.63 Median $812.83 Typical High $1,202.26 | Professional | None | $478.63 | $812.83 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $10,000.00 | Facility | None | $660.69 | $1,412.54 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $2,630.27 | Professional | None | $933.25 | $1,023.29 | $2,630.27 |
Contra Costa Health Setting Professional Modifier None Typical Low $380.19 Median $1,096.48 Typical High $1,318.26 | Professional | None | $380.19 | $1,096.48 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $2,884.03 | Professional | None | $977.24 | $1,230.27 | $2,884.03 |
Lucent Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $8,912.51 | Professional | None | $6,918.31 | $6,918.31 | $8,912.51 |
Molina Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $151,356.12 Typical High $251,188.64 | Facility | None | $851.14 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $2,630.27 | Professional | None | $933.25 | $1,023.29 | $2,630.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $3,090.30 | Professional | None | $794.33 | $1,047.13 | $3,090.30 |
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 $407.38 Median $436.52 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $177.83 Typical High $194.98 | Professional | 53 · Discontinued | $165.96 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $660.69 Typical High $724.44 | Professional | 54 · Surgery only | $616.60 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $144.54 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $87.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $616.60 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $575.44 | $616.60 | $676.08 |
Where California sits
The same service costs 7.4 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· 27th of 51
$1,288
AK $4,074TX $550
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.