How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,000 to $14,454Professionalmedian $1,660 · 10th to 90th $1,000 to $10,471
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 $7,585.78 Typical High $18,197.01 | Facility | None | $2,238.72 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,148.15 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,912.51 Typical High $16,982.44 | Facility | None | $4,677.35 | $8,912.51 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,905.46 | $2,290.87 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $1,737.80 Typical High $4,265.80 | Facility | None | $91.20 | $1,737.80 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $6,456.54 Typical High $11,481.54 | Facility | None | $758.58 | $6,456.54 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
Contra Costa Health Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,760.83 | Professional | None | $6,456.54 | $6,456.54 | $6,760.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $630.96 Typical High $831.76 | Professional | None | $141.25 | $630.96 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $10,471.29 | Professional | None | $8,511.38 | $8,511.38 | $10,471.29 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $6,456.54 Typical High $11,220.18 | Facility | None | $812.83 | $6,456.54 | $11,220.18 |
Providence Setting Professional Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $5,754.40 | Professional | None | $1,230.27 | $1,258.93 | $5,754.40 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $18,620.87 | Facility | None | $2,884.03 | $6,760.83 | $18,620.87 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $2,041.74 | Professional | None | $977.24 | $1,230.27 | $2,041.74 |
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 $524.81 Median $575.44 Typical High $602.56 | Professional | 52 · Reduced service | $524.81 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $229.09 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $851.14 Typical High $891.25 | Professional | 54 · Surgery only | $794.33 | $851.14 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $169.82 Typical High $177.83 | Professional | 55 · Aftercare only | $158.49 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $114.82 Typical High $120.23 | Professional | 56 · Pre-op care only | $104.71 | $114.82 | $120.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $323.59 Typical High $371.54 | Professional | 80 · Assistant surgeon | $204.17 | $323.59 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $281.84 Typical High $323.59 | Professional | AS · PA/NP assist | $177.83 | $281.84 | $323.59 |
Where California sits
The same service costs 5.9 times more in Texas than in Kentucky. 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· 7th of 51
$2,399
TX $5,754KY $977
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.