How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,122 to $12,589Professionalmedian $794 · 10th to 90th $589 to $3,020
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 $2,398.83 Median $9,120.11 Typical High $21,379.62 | Facility | None | $2,398.83 | $9,120.11 | $21,379.62 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $812.83 | Professional | None | $630.96 | $707.95 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $6,606.93 Typical High $13,489.63 | Facility | None | $2,951.21 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,862.09 | Professional | None | $645.65 | $794.33 | $1,862.09 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,951.21 Typical High $14,454.40 | Facility | None | $100.00 | $2,951.21 | $14,454.40 |
Blue Shield Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $1,047.13 | Professional | None | $512.86 | $758.58 | $1,047.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,412.54 | Professional | None | $776.25 | $954.99 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $4,570.88 Typical High $7,413.10 | Facility | None | $1,122.02 | $4,570.88 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,288.25 | Professional | None | $616.60 | $707.95 | $1,288.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,148.15 | Professional | None | $741.31 | $933.25 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,778.28 | Professional | None | $707.95 | $870.96 | $1,778.28 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Professional | None | $7,943.28 | $7,943.28 | $7,943.28 |
Molina Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
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 $954.99 Median $4,677.35 Typical High $9,549.93 | Facility | None | $954.99 | $4,677.35 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,230.27 | Professional | None | $616.60 | $707.95 | $1,230.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $11,220.18 | Facility | None | $1,258.93 | $3,090.30 | $11,220.18 |
United Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,318.26 | Professional | None | $575.44 | $724.44 | $1,318.26 |
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 $316.23 Median $331.13 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $131.83 Typical High $147.91 | Professional | 53 · Discontinued | $125.89 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $501.19 Typical High $549.54 | Professional | 54 · Surgery only | $467.74 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $93.33 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $66.07 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $467.74 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $436.52 | $467.74 | $512.86 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $128.82 Typical High $194.98 | Professional | 80 · Assistant surgeon | $104.71 | $128.82 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $112.20 Typical High $169.82 | Professional | AS · PA/NP assist | $91.20 | $112.20 | $169.82 |
Where California sits
The same service costs 17.4 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· 38th of 51
$794
AK $3,020TX $174
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.