How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,413 to $14,125Professionalmedian $2,042 · 10th to 90th $1,318 to $13,183
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 $1,513.56 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,513.56 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,412.54 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $11,748.98 Typical High $22,387.21 | Facility | None | $6,025.60 | $11,748.98 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $2,137.96 Typical High $5,888.44 | Professional | None | $1,949.84 | $2,137.96 | $5,888.44 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $1,949.84 Typical High $7,762.47 | Facility | None | $97.72 | $1,949.84 | $7,762.47 |
Blue Shield Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $3,890.45 | Professional | None | $1,122.02 | $1,584.89 | $3,890.45 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,548.82 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $3,548.13 Typical High $7,244.36 | Facility | None | $1,380.38 | $3,548.13 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $4,168.69 | Professional | None | $1,445.44 | $1,659.59 | $4,168.69 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,698.24 | $1,862.09 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $4,466.84 | Professional | None | $1,513.56 | $1,905.46 | $4,466.84 |
Lucent Health Setting Professional Modifier None Typical Low $13,182.57 Median $13,182.57 Typical High $14,125.38 | Professional | None | $13,182.57 | $13,182.57 | $14,125.38 |
Molina Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Providence Setting Facility Modifier None Typical Low $1,584.89 Median $3,630.78 Typical High $10,000.00 | Facility | None | $1,584.89 | $3,630.78 | $10,000.00 |
Providence Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $4,365.16 | Professional | None | $1,445.44 | $1,621.81 | $4,365.16 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,623.41 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,623.41 | $17,378.01 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $5,011.87 | Professional | None | $1,258.93 | $1,698.24 | $5,011.87 |
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 $660.69 Median $707.95 Typical High $794.33 | Professional | 52 · Reduced service | $660.69 | $707.95 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $281.84 Typical High $316.23 | Professional | 53 · Discontinued | $263.03 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,071.52 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,000.00 | $1,071.52 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $234.42 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $141.25 Typical High $158.49 | Professional | 56 · Pre-op care only | $131.83 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,000.00 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $933.25 | $1,000.00 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,071.52 Typical High $2,570.40 | Professional | 62 · Two surgeons | $851.14 | $1,071.52 | $2,570.40 |
Where California sits
The same service costs 6.6 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· 32nd of 51
$2,188
AK $6,607TX $1,000
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.