How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,349 to $16,982Professionalmedian $977 · 10th to 90th $708 to $3,548
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 $741.31 Median $776.25 Typical High $831.76 | Professional | None | $741.31 | $776.25 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $13,182.57 Typical High $23,442.29 | Facility | None | $6,760.83 | $13,182.57 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $2,290.87 | Professional | None | $933.25 | $977.24 | $2,290.87 |
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 $645.65 Median $954.99 Typical High $1,318.26 | Professional | None | $645.65 | $954.99 | $1,318.26 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,348.96 | Professional | None | $812.83 | $1,000.00 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $7,413.10 Typical High $12,302.69 | Facility | None | $1,122.02 | $7,413.10 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,412.54 | Professional | None | $812.83 | $912.01 | $1,412.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,202.26 | Professional | None | $707.95 | $891.25 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,949.84 | Professional | None | $758.58 | $933.25 | $1,949.84 |
Lucent Health Setting Professional Modifier None Typical Low $13,803.84 Median $13,803.84 Typical High $13,803.84 | Professional | None | $13,803.84 | $13,803.84 | $13,803.84 |
Molina Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $1,023.29 Median $6,918.31 Typical High $12,589.25 | Facility | None | $1,023.29 | $6,918.31 | $12,589.25 |
Providence Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,348.96 | Professional | None | $812.83 | $912.01 | $1,348.96 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
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 $660.69 Median $831.76 Typical High $1,445.44 | Professional | None | $660.69 | $831.76 | $1,445.44 |
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 $371.54 Median $389.05 Typical High $416.87 | Professional | 52 · Reduced service | $371.54 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $154.88 Typical High $165.96 | Professional | 53 · Discontinued | $147.91 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $588.84 Typical High $630.96 | Professional | 54 · Surgery only | $549.54 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $117.49 Typical High $125.89 | Professional | 55 · Aftercare only | $109.65 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $77.62 Typical High $83.18 | Professional | 56 · Pre-op care only | $74.13 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $549.54 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $512.86 | $549.54 | $588.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $144.54 Typical High $239.88 | Professional | 80 · Assistant surgeon | $117.49 | $144.54 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $125.89 Typical High $213.80 | Professional | AS · PA/NP assist | $102.33 | $125.89 | $213.80 |
Where California sits
The same service costs 17.8 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
$977
AK $3,388TX $191
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.