How much rates vary
Facilitymedian $4,677 · 10th to 90th $871 to $13,183Professionalmedian $708 · 10th to 90th $525 to $3,467
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 $812.83 Median $7,244.36 Typical High $17,782.79 | Facility | None | $812.83 | $7,244.36 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $812.83 | Professional | None | $549.54 | $660.69 | $812.83 |
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 $549.54 Median $707.95 Typical High $1,778.28 | Professional | None | $549.54 | $707.95 | $1,778.28 |
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 $457.09 Median $645.65 Typical High $891.25 | Professional | None | $457.09 | $645.65 | $891.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $346.74 Median $794.33 Typical High $1,096.48 | Professional | None | $346.74 | $794.33 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,466.84 Typical High $7,413.10 | Facility | None | $758.58 | $4,466.84 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,258.93 | Professional | None | $602.56 | $758.58 | $1,258.93 |
Contra Costa Health Setting Professional Modifier None Typical Low $208.93 Median $776.25 Typical High $1,071.52 | Professional | None | $208.93 | $776.25 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,862.09 | Professional | None | $602.56 | $851.14 | $1,862.09 |
Lucent Health Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,456.54 | Professional | None | $5,623.41 | $5,623.41 | $6,456.54 |
Molina Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,071.52 | Professional | None | $645.65 | $645.65 | $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 $758.58 Median $4,073.80 Typical High $7,762.47 | Facility | None | $758.58 | $4,073.80 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,202.26 | Professional | None | $602.56 | $758.58 | $1,202.26 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,630.27 | Professional | None | $2,089.30 | $2,089.30 | $2,630.27 |
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 $501.19 Median $676.08 Typical High $1,348.96 | Professional | None | $501.19 | $676.08 | $1,348.96 |
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 $295.12 Median $331.13 Typical High $407.38 | Facility | 52 · Reduced service | $295.12 | $331.13 | $407.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $117.49 Median $131.83 Typical High $162.18 | Facility | 53 · Discontinued | $117.49 | $131.83 | $162.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $446.68 Median $489.78 Typical High $616.60 | Facility | 54 · Surgery only | $446.68 | $489.78 | $616.60 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $89.13 Median $97.72 Typical High $123.03 | Facility | 55 · Aftercare only | $89.13 | $97.72 | $123.03 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $58.88 Median $66.07 Typical High $81.28 | Facility | 56 · Pre-op care only | $58.88 | $66.07 | $81.28 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $457.09 Typical High $575.44 | Facility | 78 · Unplanned return to OR | $416.87 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $331.13 Typical High $407.38 | Professional | 52 · Reduced service | $275.42 | $331.13 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $131.83 Typical High $162.18 | Professional | 53 · Discontinued | $109.65 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $489.78 Typical High $616.60 | Professional | 54 · Surgery only | $416.87 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $97.72 Typical High $123.03 | Professional | 55 · Aftercare only | $83.18 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $66.07 Typical High $81.28 | Professional | 56 · Pre-op care only | $54.95 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $457.09 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $389.05 | $457.09 | $575.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $117.49 Typical High $169.82 | Professional | 80 · Assistant surgeon | $93.33 | $117.49 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $104.71 Typical High $151.36 | Professional | AS · PA/NP assist | $83.18 | $104.71 | $151.36 |
Where California sits
The same service costs 6.6 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· 42nd of 51
$724
AK $3,020TX $457
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.