How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,122 to $12,882Professionalmedian $794 · 10th to 90th $617 to $2,754
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 $660.69 Median $724.44 Typical High $1,096.48 | Professional | None | $660.69 | $724.44 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,511.38 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,862.09 | Professional | None | $724.44 | $794.33 | $1,862.09 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,951.21 Typical High $14,125.38 | Facility | None | $100.00 | $2,951.21 | $14,125.38 |
Blue Shield Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $1,071.52 | Professional | None | $524.81 | $776.25 | $1,071.52 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,412.54 | Professional | None | $707.95 | $870.96 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $4,570.88 Typical High $9,120.11 | Facility | None | $1,122.02 | $4,570.88 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,202.26 | Professional | None | $676.08 | $758.58 | $1,202.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,047.13 | Professional | None | $741.31 | $851.14 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,698.24 | Professional | None | $676.08 | $831.76 | $1,698.24 |
Lucent Health Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,606.93 | $6,606.93 | $6,606.93 |
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 $10,471.29 | Facility | None | $954.99 | $4,677.35 | $10,471.29 |
Providence Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,174.90 | Professional | None | $676.08 | $741.31 | $1,174.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 $1,230.27 | Professional | None | $575.44 | $724.44 | $1,230.27 |
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 $354.81 | Professional | 52 · Reduced service | $316.23 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $131.83 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $501.19 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $100.00 | $107.15 |
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 $501.19 | Professional | 78 · Unplanned return to OR | $436.52 | $467.74 | $501.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $123.03 Typical High $204.17 | Professional | 80 · Assistant surgeon | $97.72 | $123.03 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $107.15 Typical High $177.83 | Professional | AS · PA/NP assist | $87.10 | $107.15 | $177.83 |
Where California sits
The same service costs 8.5 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· 38th of 51
$813
AK $3,020TX $355
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.