How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,122 to $20,893Professionalmedian $1,479 · 10th to 90th $977 to $8,511
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 $2,818.38 Median $9,549.93 Typical High $21,379.62 | Facility | None | $2,818.38 | $9,549.93 | $21,379.62 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,479.11 | Professional | None | $977.24 | $1,174.90 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $14,791.08 Typical High $33,113.11 | Facility | None | $7,244.36 | $14,791.08 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $4,365.16 | Professional | None | $1,096.48 | $1,584.89 | $4,365.16 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,621.81 Typical High $12,882.50 | Facility | None | $100.00 | $1,621.81 | $12,882.50 |
Blue Shield Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $2,344.23 | Professional | None | $851.14 | $1,202.26 | $2,344.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $2,238.72 | Professional | None | $933.25 | $1,148.15 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $9,332.54 Median $14,791.08 Typical High $24,547.09 | Facility | None | $9,332.54 | $14,791.08 | $24,547.09 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $3,019.95 | Professional | None | $1,071.52 | $1,230.27 | $3,019.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,230.27 | Professional | None | $812.83 | $1,047.13 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $2,754.23 | Professional | None | $933.25 | $1,174.90 | $2,754.23 |
Lucent Health Setting Professional Modifier None Typical Low $8,511.38 Median $9,120.11 Typical High $9,120.11 | Professional | None | $8,511.38 | $9,120.11 | $9,120.11 |
Molina Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Providence Setting Facility Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $20,892.96 | Facility | None | $1,174.90 | $1,659.59 | $20,892.96 |
Providence Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $3,019.95 | Professional | None | $1,071.52 | $1,202.26 | $3,019.95 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $19,498.45 | Facility | None | $2,884.03 | $6,760.83 | $19,498.45 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $3,090.30 | Professional | None | $891.25 | $1,202.26 | $3,090.30 |
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 $501.19 Median $537.03 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $870.96 | Professional | 54 · Surgery only | $758.58 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $173.78 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $812.83 |
Where California sits
The same service costs 8.9 times more in Oklahoma 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· 28th of 51
$1,660
OK $7,762TX $871
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.