How much rates vary
Facilitymedian $4,898 · 10th to 90th $955 to $14,125Professionalmedian $776 · 10th to 90th $575 to $1,698
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 $912.01 Median $7,943.28 Typical High $18,620.87 | Facility | None | $912.01 | $7,943.28 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $977.24 | Professional | None | $616.60 | $794.33 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $11,481.54 Typical High $20,417.38 | Facility | None | $5,888.44 | $11,481.54 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $2,290.87 | Professional | None | $741.31 | $758.58 | $2,290.87 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,951.21 Typical High $10,964.78 | Facility | None | $100.00 | $2,951.21 | $10,964.78 |
Blue Shield Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $1,000.00 | Professional | None | $489.78 | $707.95 | $1,000.00 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,148.15 | Professional | None | $616.60 | $812.83 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,466.84 Typical High $8,912.51 | Facility | None | $851.14 | $4,466.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,288.25 | Professional | None | $602.56 | $794.33 | $1,288.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $1,122.02 | Professional | None | $478.63 | $741.31 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $1,862.09 | Professional | None | $575.44 | $891.25 | $1,862.09 |
Lucent Health Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Professional | None | $10,000.00 | $10,000.00 | $10,000.00 |
Molina Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,122.02 | Professional | None | $660.69 | $660.69 | $1,122.02 |
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 $794.33 Median $4,073.80 Typical High $9,772.37 | Facility | None | $794.33 | $4,073.80 | $9,772.37 |
Providence Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,230.27 | Professional | None | $602.56 | $794.33 | $1,230.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,995.26 | $1,995.26 | $2,691.53 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,754.40 | $17,378.01 |
United Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $1,380.38 | Professional | None | $489.78 | $707.95 | $1,380.38 |
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 $436.52 | Facility | 52 · Reduced service | $309.03 | $338.84 | $436.52 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $177.83 | Facility | 53 · Discontinued | $123.03 | $134.90 | $177.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $467.74 Median $501.19 Typical High $660.69 | Facility | 54 · Surgery only | $467.74 | $501.19 | $660.69 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $93.33 Median $100.00 Typical High $131.83 | Facility | 55 · Aftercare only | $93.33 | $100.00 | $131.83 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $89.13 | Facility | 56 · Pre-op care only | $61.66 | $67.61 | $89.13 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $467.74 Typical High $616.60 | Facility | 78 · Unplanned return to OR | $436.52 | $467.74 | $616.60 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $346.74 Typical High $416.87 | Professional | 52 · Reduced service | $288.40 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $141.25 Typical High $165.96 | Professional | 53 · Discontinued | $114.82 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $524.81 Typical High $616.60 | Professional | 54 · Surgery only | $436.52 | $524.81 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $104.71 Typical High $125.89 | Professional | 55 · Aftercare only | $87.10 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $69.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $57.54 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $489.78 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $407.38 | $489.78 | $575.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $128.82 Typical High $165.96 | Professional | 80 · Assistant surgeon | $97.72 | $128.82 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $112.20 Typical High $144.54 | Professional | AS · PA/NP assist | $87.10 | $112.20 | $144.54 |
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· 35th of 51
$794
AK $3,020TX $490
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.