How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,445 to $16,596Professionalmedian $1,479 · 10th to 90th $1,148 to $9,333
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 $1,096.48 Median $1,202.26 Typical High $4,073.80 | Professional | None | $1,096.48 | $1,202.26 | $4,073.80 |
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 $1,230.27 Median $1,380.38 Typical High $5,128.61 | Professional | None | $1,230.27 | $1,380.38 | $5,128.61 |
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 $1,047.13 Median $1,479.11 Typical High $3,548.13 | Professional | None | $1,047.13 | $1,479.11 | $3,548.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,445.44 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $4,570.88 Typical High $9,120.11 | Facility | None | $1,148.15 | $4,570.88 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $3,548.13 | Professional | None | $1,202.26 | $1,412.54 | $3,548.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $794.33 Median $1,445.44 Typical High $1,737.80 | Professional | None | $794.33 | $1,445.44 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,951.21 | Professional | None | $1,230.27 | $1,548.82 | $2,951.21 |
Lucent Health Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $10,232.93 | Professional | None | $9,332.54 | $9,332.54 | $10,232.93 |
Molina Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Providence Setting Facility Modifier None Typical Low $1,148.15 Median $4,677.35 Typical High $10,232.93 | Facility | None | $1,148.15 | $4,677.35 | $10,232.93 |
Providence Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $3,548.13 | Professional | None | $1,202.26 | $1,380.38 | $3,548.13 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Professional | None | $4,168.69 | $4,168.69 | $4,168.69 |
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 $1,000.00 Median $1,348.96 Typical High $3,801.89 | Professional | None | $1,000.00 | $1,348.96 | $3,801.89 |
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 $549.54 Median $602.56 Typical High $645.65 | Professional | 52 · Reduced service | $549.54 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $239.88 Typical High $263.03 | Professional | 53 · Discontinued | $218.78 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $912.01 Typical High $977.24 | Professional | 54 · Surgery only | $812.83 | $912.01 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $181.97 Typical High $194.98 | Professional | 55 · Aftercare only | $162.18 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $120.23 Typical High $128.82 | Professional | 56 · Pre-op care only | $109.65 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $851.14 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $758.58 | $851.14 | $912.01 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,862.09 Typical High $4,466.84 | Professional | 50 · Both sides | $1,513.56 | $1,862.09 | $4,466.84 |
Where California sits
The same service costs 6.2 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· 22nd of 51
$1,905
AK $5,248UT $851
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.