How much rates vary
Facilitymedian $1,202 · 10th to 90th $457 to $9,333Professionalmedian $977 · 10th to 90th $631 to $6,607
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 $602.56 Median $630.96 Typical High $831.76 | Professional | None | $602.56 | $630.96 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $7,943.28 Typical High $16,982.44 | Facility | None | $3,630.78 | $7,943.28 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $2,238.72 | Professional | None | $707.95 | $1,000.00 | $2,238.72 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $741.31 Typical High $6,918.31 | Facility | None | $100.00 | $741.31 | $6,918.31 |
Blue Shield Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $1,071.52 | Professional | None | $524.81 | $776.25 | $1,071.52 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,174.90 | Professional | None | $851.14 | $1,148.15 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $831.76 Typical High $1,621.81 | Facility | None | $575.44 | $831.76 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,445.44 | Professional | None | $741.31 | $812.83 | $1,445.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $616.60 Median $1,047.13 Typical High $1,174.90 | Professional | None | $616.60 | $1,047.13 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $2,570.40 | Professional | None | $870.96 | $1,122.02 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $8,511.38 | Professional | None | $6,606.93 | $6,606.93 | $8,511.38 |
Molina Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $549.54 Median $933.25 Typical High $4,168.69 | Facility | None | $549.54 | $933.25 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,412.54 | Professional | None | $741.31 | $794.33 | $1,412.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,230.27 Typical High $4,677.35 | Facility | None | $398.11 | $1,230.27 | $4,677.35 |
United Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,445.44 | Professional | None | $676.08 | $891.25 | $1,445.44 |
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 $302.00 Median $316.23 Typical High $338.84 | Professional | 52 · Reduced service | $302.00 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $125.89 Typical High $138.04 | Professional | 53 · Discontinued | $120.23 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $457.09 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $95.50 Typical High $102.33 | Professional | 55 · Aftercare only | $91.20 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $63.10 Typical High $69.18 | Professional | 56 · Pre-op care only | $60.26 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $426.58 | $436.52 | $478.63 |
Where California sits
The same service costs 22.4 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· 37th of 51
$977
AK $3,981TX $178
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.