How much rates vary
Facilitymedian $2,042 · 10th to 90th $537 to $9,333Professionalmedian $912 · 10th to 90th $759 to $7,586
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 $6,309.57 Typical High $16,218.10 | Facility | None | $1,905.46 | $6,309.57 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $933.25 | Professional | None | $741.31 | $776.25 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $14,125.38 | Facility | None | $2,884.03 | $6,309.57 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $2,398.83 | Professional | None | $776.25 | $794.33 | $2,398.83 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $741.31 Typical High $6,165.95 | Facility | None | $100.00 | $741.31 | $6,165.95 |
Blue Shield Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,174.90 | Professional | None | $588.84 | $870.96 | $1,174.90 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,288.25 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $3,311.31 | Facility | None | $758.58 | $1,513.56 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,659.59 | Professional | None | $776.25 | $933.25 | $1,659.59 |
Contra Costa Health Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,412.54 | Professional | None | $891.25 | $1,174.90 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $2,951.21 | Professional | None | $1,000.00 | $1,258.93 | $2,951.21 |
Lucent Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $9,772.37 | Professional | None | $7,585.78 | $7,585.78 | $9,772.37 |
Molina Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $676.08 Median $1,584.89 Typical High $4,897.79 | Facility | None | $676.08 | $1,584.89 | $4,897.79 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,621.81 | Professional | None | $776.25 | $912.01 | $1,621.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $11,220.18 | Facility | None | $1,258.93 | $3,090.30 | $11,220.18 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,659.59 | Professional | None | $758.58 | $1,000.00 | $1,659.59 |
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 $371.54 Median $389.05 Typical High $416.87 | Professional | 52 · Reduced service | $371.54 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $154.88 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $575.44 Typical High $630.96 | Professional | 54 · Surgery only | $549.54 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $117.49 Typical High $125.89 | Professional | 55 · Aftercare only | $112.20 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $77.62 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $537.03 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $512.86 | $537.03 | $588.84 |
Where California sits
The same service costs 5.9 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· 49th of 51
$955
AK $4,467TX $759
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.