How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,380 to $16,596Professionalmedian $1,175 · 10th to 90th $933 to $7,413
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 $2,398.83 Median $9,120.11 Typical High $21,379.62 | Facility | None | $2,398.83 | $9,120.11 | $21,379.62 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $3,801.89 | Professional | None | $891.25 | $1,000.00 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $13,182.57 Typical High $23,442.29 | Facility | None | $6,760.83 | $13,182.57 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $4,168.69 | Professional | None | $1,023.29 | $1,148.15 | $4,168.69 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,951.21 Typical High $14,125.38 | Facility | None | $100.00 | $2,951.21 | $14,125.38 |
Blue Shield Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $2,884.03 | Professional | None | $831.76 | $1,174.90 | $2,884.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,202.26 | Professional | None | $794.33 | $1,148.15 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $4,570.88 Typical High $9,120.11 | Facility | None | $1,122.02 | $4,570.88 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,148.15 | $2,884.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $630.96 Median $1,071.52 Typical High $1,288.25 | Professional | None | $630.96 | $1,071.52 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $2,398.83 | Professional | None | $933.25 | $1,174.90 | $2,398.83 |
Lucent Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,762.47 | Professional | None | $7,413.10 | $7,413.10 | $7,762.47 |
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 |
Providence Setting Facility Modifier None Typical Low $1,096.48 Median $4,677.35 Typical High $10,471.29 | Facility | None | $1,096.48 | $4,677.35 | $10,471.29 |
Providence Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $2,884.03 | Professional | None | $977.24 | $1,122.02 | $2,884.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,754.40 | $17,378.01 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $3,019.95 | Professional | None | $812.83 | $1,096.48 | $3,019.95 |
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 $446.68 Median $489.78 Typical High $524.81 | Professional | 52 · Reduced service | $446.68 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $199.53 Typical High $208.93 | Professional | 53 · Discontinued | $177.83 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $741.31 Typical High $794.33 | Professional | 54 · Surgery only | $676.08 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $147.91 Typical High $158.49 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $100.00 Typical High $104.71 | Professional | 56 · Pre-op care only | $89.13 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $691.83 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $630.96 | $691.83 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,584.89 Typical High $3,630.78 | Professional | 50 · Both sides | $1,258.93 | $1,584.89 | $3,630.78 |
Where California sits
The same service costs 7.2 times more in Oklahoma 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· 23rd of 51
$1,585
OK $4,677UT $646
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.