How much rates vary
Facilitymedian $3,020 · 10th to 90th $95 to $5,754Professionalmedian $2,089 · 10th to 90th $1,995 to $5,495
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 $2,089.30 Median $2,089.30 Typical High $3,630.78 | Facility | None | $2,089.30 | $2,089.30 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $2,398.83 | Professional | None | $2,089.30 | $2,238.72 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,467.37 Typical High $7,079.46 | Facility | None | $2,238.72 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $12,882.50 | Professional | None | $1,995.26 | $1,995.26 | $12,882.50 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $2,238.72 Typical High $3,388.44 | Facility | None | $75.86 | $2,238.72 | $3,388.44 |
Blue Shield Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $5,623.41 | Professional | None | $2,089.30 | $2,511.89 | $5,623.41 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $3,090.30 | Professional | None | $1,862.09 | $2,290.87 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,137.96 | $3,801.89 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $5,495.41 | Professional | None | $1,862.09 | $2,398.83 | $5,495.41 |
Providence Setting Facility Modifier None Typical Low $2,089.30 Median $3,715.35 Typical High $5,754.40 | Facility | None | $2,089.30 | $3,715.35 | $5,754.40 |
Providence Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,238.72 | Professional | None | $2,089.30 | $2,089.30 | $2,238.72 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
United Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $5,623.41 | Facility | None | $2,089.30 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $5,495.41 | Professional | None | $1,995.26 | $1,995.26 | $5,495.41 |
4 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 $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $1,023.29 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $309.03 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $208.93 |
Where California sits
The same service costs 2.0 times more in Alaska than in Oklahoma. 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· 12th of 51
$2,239
AK $3,548OK $1,778
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.