How much rates vary
Facilitymedian $1,585 · 10th to 90th $155 to $8,128Professionalmedian $324 · 10th to 90th $234 to $1,072
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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $263.03 | Professional | None | $234.42 | $257.04 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,606.93 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $323.59 Typical High $724.44 | Professional | None | $309.03 | $323.59 | $724.44 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $1,479.11 Typical High $5,370.32 | Facility | None | $95.50 | $1,479.11 | $5,370.32 |
Blue Shield Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $436.52 | Professional | None | $213.80 | $316.23 | $436.52 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $446.68 | Professional | None | $234.42 | $288.40 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,174.90 Typical High $5,623.41 | Facility | None | $660.69 | $1,174.90 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $426.58 | Professional | None | $263.03 | $288.40 | $426.58 |
Contra Costa Health Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $309.03 | Professional | None | $234.42 | $281.84 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $691.83 | Professional | None | $229.09 | $295.12 | $691.83 |
Lucent Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
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 $302.00 Median $870.96 Typical High $5,623.41 | Facility | None | $302.00 | $870.96 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $426.58 | Professional | None | $263.03 | $288.40 | $426.58 |
Sutter Health Plus Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
United Setting Facility Modifier None Typical Low $123.03 Median $501.19 Typical High $3,090.30 | Facility | None | $123.03 | $501.19 | $3,090.30 |
United Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $436.52 | Professional | None | $218.78 | $275.42 | $436.52 |
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 $120.23 Median $128.82 Typical High $131.83 | Professional | 52 · Reduced service | $120.23 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $51.29 Typical High $52.48 | Professional | 53 · Discontinued | $47.86 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $190.55 Typical High $194.98 | Professional | 54 · Surgery only | $181.97 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.02 Typical High $39.81 | Professional | 55 · Aftercare only | $36.31 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.70 Typical High $26.30 | Professional | 56 · Pre-op care only | $23.99 | $25.70 | $26.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $151.36 Median $186.21 Typical High $323.59 | Professional | 62 · Two surgeons | $151.36 | $186.21 | $323.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.02 Median $47.86 Typical High $83.18 | Professional | 80 · Assistant surgeon | $38.02 | $47.86 | $83.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $41.69 Typical High $72.44 | Professional | AS · PA/NP assist | $33.11 | $41.69 | $72.44 |
Where California sits
The same service costs 36.0 times more in Alabama than in Delaware. 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.
Physician feeFacility fee
AL $15,122DE $421
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.