How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,413 to $14,454Professionalmedian $2,818 · 10th to 90th $2,089 to $20,417
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 $1,995.26 Median $2,089.30 Typical High $2,344.23 | Professional | None | $1,995.26 | $2,089.30 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,715.19 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $7,244.36 | Professional | None | $2,818.38 | $2,818.38 | $7,244.36 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,548.13 Typical High $10,964.78 | Facility | None | $100.00 | $3,548.13 | $10,964.78 |
Blue Shield Setting Professional Modifier None Typical Low $1,949.84 Median $2,818.38 Typical High $3,890.45 | Professional | None | $1,949.84 | $2,818.38 | $3,890.45 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,570.40 Median $3,162.28 Typical High $4,168.69 | Professional | None | $2,570.40 | $3,162.28 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,370.32 Typical High $10,715.19 | Facility | None | $758.58 | $5,370.32 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,630.27 Typical High $4,466.84 | Professional | None | $2,290.87 | $2,630.27 | $4,466.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,818.38 Typical High $3,801.89 | Professional | None | $2,238.72 | $2,818.38 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $3,019.95 Typical High $6,309.57 | Professional | None | $2,344.23 | $3,019.95 | $6,309.57 |
Lucent Health Setting Professional Modifier None Typical Low $20,417.38 Median $20,417.38 Typical High $21,877.62 | Professional | None | $20,417.38 | $20,417.38 | $21,877.62 |
Molina Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $5,128.61 Typical High $10,715.19 | Facility | None | $812.83 | $5,128.61 | $10,715.19 |
Providence Setting Professional Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $4,365.16 | Professional | None | $2,187.76 | $2,630.27 | $4,365.16 |
Sutter Health Plus Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Professional | None | $9,120.11 | $9,120.11 | $9,120.11 |
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 $2,137.96 Median $2,691.53 Typical High $4,570.88 | Professional | None | $2,137.96 | $2,691.53 | $4,570.88 |
8 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 $1,000.00 Median $1,047.13 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,000.00 | $1,047.13 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $416.87 Typical High $446.68 | Professional | 53 · Discontinued | $407.38 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,584.89 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,513.56 | $1,584.89 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $316.23 Typical High $331.13 | Professional | 55 · Aftercare only | $302.00 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $208.93 Typical High $223.87 | Professional | 56 · Pre-op care only | $199.53 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,479.11 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,479.11 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $457.09 Typical High $776.25 | Professional | 80 · Assistant surgeon | $363.08 | $457.09 | $776.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $398.11 Typical High $691.83 | Professional | AS · PA/NP assist | $323.59 | $398.11 | $691.83 |
Where California sits
The same service costs 19.5 times more in Alaska 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· 37th of 51
$2,951
AK $11,482TX $589
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.