How much rates vary
Facilitymedian $2,951 · 10th to 90th $891 to $11,482Professionalmedian $1,047 · 10th to 90th $871 to $7,762
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 $831.76 Median $891.25 Typical High $1,318.26 | Professional | None | $831.76 | $891.25 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $8,128.31 Typical High $16,982.44 | Facility | None | $3,890.45 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $954.99 Typical High $3,548.13 | Professional | None | $933.25 | $954.99 | $3,548.13 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,513.56 Typical High $8,128.31 | Facility | None | $100.00 | $1,513.56 | $8,128.31 |
Blue Shield Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,380.38 | Professional | None | $724.44 | $1,023.29 | $1,380.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,258.93 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,949.84 Typical High $3,981.07 | Facility | None | $645.65 | $1,949.84 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,949.84 | Professional | None | $891.25 | $1,047.13 | $1,949.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,513.56 | Professional | None | $794.33 | $1,122.02 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $2,454.71 | Professional | None | $912.01 | $1,148.15 | $2,454.71 |
Lucent Health Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,943.28 | Professional | None | $7,762.47 | $7,762.47 | $7,943.28 |
Molina Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $2,041.74 Typical High $5,623.41 | Facility | None | $707.95 | $2,041.74 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,819.70 | Professional | None | $891.25 | $1,047.13 | $1,819.70 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,495.41 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,495.41 | $17,378.01 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,862.09 | Professional | None | $831.76 | $1,047.13 | $1,862.09 |
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 $416.87 Median $446.68 Typical High $501.19 | Professional | 52 · Reduced service | $416.87 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $204.17 | Professional | 53 · Discontinued | $169.82 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $660.69 Typical High $758.58 | Professional | 54 · Surgery only | $630.96 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $151.36 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $89.13 Typical High $100.00 | Professional | 56 · Pre-op care only | $83.18 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $616.60 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $588.84 | $616.60 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,479.11 Typical High $2,290.87 | Professional | 50 · Both sides | $1,230.27 | $1,479.11 | $2,290.87 |
Where California sits
The same service costs 7.6 times more in Alaska 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· 38th of 51
$1,202
AK $4,365UT $575
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.