How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,047 to $12,303Professionalmedian $741 · 10th to 90th $537 to $1,549
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 $831.76 Median $7,943.28 Typical High $20,892.96 | Facility | None | $831.76 | $7,943.28 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $794.33 | Professional | None | $562.34 | $676.08 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,584.89 | Professional | None | $562.34 | $741.31 | $1,584.89 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,951.21 Typical High $13,803.84 | Facility | None | $100.00 | $2,951.21 | $13,803.84 |
Blue Shield Setting Professional Modifier None Typical Low $501.19 Median $741.31 Typical High $1,000.00 | Professional | None | $501.19 | $741.31 | $1,000.00 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $1,148.15 | Professional | None | $524.81 | $741.31 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $3,388.44 Typical High $6,165.95 | Facility | None | $1,148.15 | $3,388.44 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,096.48 | Professional | None | $645.65 | $776.25 | $1,096.48 |
Contra Costa Health Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $891.25 | Professional | None | $575.44 | $776.25 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,584.89 | Professional | None | $501.19 | $724.44 | $1,584.89 |
Lucent Health Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $891.25 | Professional | None | $537.03 | $537.03 | $891.25 |
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 $831.76 Median $3,235.94 Typical High $7,244.36 | Facility | None | $831.76 | $3,235.94 | $7,244.36 |
Providence Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $1,071.52 | Professional | None | $645.65 | $741.31 | $1,071.52 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,905.46 | $1,905.46 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,090.30 | $10,964.78 |
United Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $1,148.15 | Professional | None | $457.09 | $630.96 | $1,148.15 |
14 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 Facility Modifier 52 · Reduced service Typical Low $309.03 Median $338.84 Typical High $416.87 | Facility | 52 · Reduced service | $309.03 | $338.84 | $416.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $165.96 | Facility | 53 · Discontinued | $123.03 | $134.90 | $165.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $457.09 Median $512.86 Typical High $616.60 | Facility | 54 · Surgery only | $457.09 | $512.86 | $616.60 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $91.20 Median $102.33 Typical High $123.03 | Facility | 55 · Aftercare only | $91.20 | $102.33 | $123.03 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $83.18 | Facility | 56 · Pre-op care only | $61.66 | $67.61 | $83.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $478.63 Typical High $575.44 | Facility | 78 · Unplanned return to OR | $426.58 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $338.84 Typical High $371.54 | Professional | 52 · Reduced service | $288.40 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $134.90 Typical High $147.91 | Professional | 53 · Discontinued | $114.82 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $512.86 Typical High $562.34 | Professional | 54 · Surgery only | $436.52 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $102.33 Typical High $112.20 | Professional | 55 · Aftercare only | $87.10 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $67.61 Typical High $74.13 | Professional | 56 · Pre-op care only | $57.54 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $478.63 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $407.38 | $478.63 | $524.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $112.20 Typical High $158.49 | Professional | 80 · Assistant surgeon | $91.20 | $112.20 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $97.72 Typical High $138.04 | Professional | AS · PA/NP assist | $79.43 | $97.72 | $138.04 |
Where California sits
The same service costs 6.2 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· 33rd of 51
$741
AK $2,570TX $417
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.