How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,000 to $13,490Professionalmedian $794 · 10th to 90th $589 to $2,951
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 $2,570.40 Median $8,912.51 Typical High $19,054.61 | Facility | None | $2,570.40 | $8,912.51 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $691.83 | Professional | None | $602.56 | $645.65 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $11,220.18 Typical High $20,417.38 | Facility | None | $5,370.32 | $11,220.18 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $1,949.84 | Professional | None | $776.25 | $794.33 | $1,949.84 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $10,000.00 | Facility | None | $100.00 | $2,137.96 | $10,000.00 |
Blue Shield Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,071.52 | Professional | None | $524.81 | $758.58 | $1,071.52 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,174.90 | Professional | None | $707.95 | $870.96 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,570.40 Typical High $5,128.61 | Facility | None | $851.14 | $2,570.40 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $1,148.15 | Professional | None | $660.69 | $741.31 | $1,148.15 |
Contra Costa Health Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,047.13 | Professional | None | $616.60 | $776.25 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,659.59 | Professional | None | $660.69 | $812.83 | $1,659.59 |
Lucent Health Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $812.83 Median $2,630.27 Typical High $6,918.31 | Facility | None | $812.83 | $2,630.27 | $6,918.31 |
Providence Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $1,122.02 | Professional | None | $660.69 | $724.44 | $1,122.02 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,365.16 | $14,454.40 |
United Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,174.90 | Professional | None | $549.54 | $691.83 | $1,174.90 |
10 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 $302.00 Median $323.59 Typical High $346.74 | Professional | 52 · Reduced service | $302.00 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $128.82 Typical High $138.04 | Professional | 53 · Discontinued | $120.23 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $478.63 Typical High $512.86 | Professional | 54 · Surgery only | $457.09 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $97.72 Typical High $104.71 | Professional | 55 · Aftercare only | $91.20 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $64.57 Typical High $69.18 | Professional | 56 · Pre-op care only | $60.26 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $446.68 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $426.58 | $446.68 | $478.63 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,096.48 Typical High $1,819.70 | Professional | 50 · Both sides | $870.96 | $1,096.48 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $467.74 Typical High $776.25 | Professional | 62 · Two surgeons | $363.08 | $467.74 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $117.49 Typical High $194.98 | Professional | 80 · Assistant surgeon | $93.33 | $117.49 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $102.33 Typical High $169.82 | Professional | AS · PA/NP assist | $81.28 | $102.33 | $169.82 |
Where California sits
The same service costs 8.7 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
$813
AK $2,951TX $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.