How much rates vary
Facilitymedian $4,467 · 10th to 90th $955 to $12,303Professionalmedian $851 · 10th to 90th $631 to $5,248
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 $2,238.72 Median $7,585.78 Typical High $18,197.01 | Facility | None | $2,238.72 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $794.33 | Professional | None | $630.96 | $724.44 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,232.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,737.80 | Professional | None | $676.08 | $851.14 | $1,737.80 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,884.03 Typical High $10,232.93 | Facility | None | $100.00 | $2,884.03 | $10,232.93 |
Blue Shield Setting Professional Modifier None Typical Low $616.60 Median $891.25 Typical High $1,258.93 | Professional | None | $616.60 | $891.25 | $1,258.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $912.01 | Professional | None | $630.96 | $870.96 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,466.84 Typical High $8,912.51 | Facility | None | $758.58 | $4,466.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,258.93 | Professional | None | $724.44 | $831.76 | $1,258.93 |
Contra Costa Health Setting Professional Modifier None Typical Low $478.63 Median $776.25 Typical High $977.24 | Professional | None | $478.63 | $776.25 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,584.89 | Professional | None | $630.96 | $794.33 | $1,584.89 |
Lucent Health Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,370.32 | Professional | None | $5,248.07 | $5,248.07 | $5,370.32 |
Molina Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
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 $776.25 Median $4,265.80 Typical High $10,000.00 | Facility | None | $776.25 | $4,265.80 | $10,000.00 |
Providence Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,174.90 | Professional | None | $707.95 | $831.76 | $1,174.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
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 $501.19 Median $707.95 Typical High $1,122.02 | Professional | None | $501.19 | $707.95 | $1,122.02 |
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 $323.59 Median $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $323.59 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $128.82 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $537.03 Typical High $588.84 | Professional | 54 · Surgery only | $478.63 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $120.23 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $72.44 Typical High $79.43 | Professional | 56 · Pre-op care only | $64.57 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $501.19 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $446.68 | $501.19 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $104.71 Typical High $177.83 | Professional | 80 · Assistant surgeon | $83.18 | $104.71 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $91.20 Typical High $154.88 | Professional | AS · PA/NP assist | $74.13 | $91.20 | $154.88 |
Where California sits
The same service costs 8.1 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· 31st of 51
$871
AK $2,754TX $339
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.