How much rates vary
Facilitymedian $3,467 · 10th to 90th $759 to $10,000Professionalmedian $631 · 10th to 90th $479 to $4,467
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 $1,905.46 Median $6,165.95 Typical High $15,848.93 | Facility | None | $1,905.46 | $6,165.95 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $549.54 | Professional | None | $478.63 | $512.86 | $549.54 |
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 $549.54 Median $630.96 Typical High $1,479.11 | Professional | None | $549.54 | $630.96 | $1,479.11 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,089.30 Typical High $7,413.10 | Facility | None | $100.00 | $2,089.30 | $7,413.10 |
Blue Shield Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $812.83 | Professional | None | $398.11 | $588.84 | $812.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $724.44 | Professional | None | $398.11 | $588.84 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $3,162.28 Typical High $6,309.57 | Facility | None | $575.44 | $3,162.28 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $933.25 | Professional | None | $512.86 | $575.44 | $933.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $269.15 Median $645.65 Typical High $812.83 | Professional | None | $269.15 | $645.65 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,318.26 | Professional | None | $549.54 | $676.08 | $1,318.26 |
Lucent Health Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,786.30 | Professional | None | $4,466.84 | $4,466.84 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
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 $602.56 Median $3,019.95 Typical High $6,760.83 | Facility | None | $602.56 | $3,019.95 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $891.25 | Professional | None | $512.86 | $575.44 | $891.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $446.68 Median $562.34 Typical High $933.25 | Professional | None | $446.68 | $562.34 | $933.25 |
9 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 $239.88 Median $257.04 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $109.65 | Professional | 53 · Discontinued | $95.50 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $354.81 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $338.84 | $354.81 | $389.05 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $870.96 Typical High $1,445.44 | Professional | 50 · Both sides | $676.08 | $870.96 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $91.20 Typical High $154.88 | Professional | 80 · Assistant surgeon | $72.44 | $91.20 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $81.28 Typical High $134.90 | Professional | AS · PA/NP assist | $63.10 | $81.28 | $134.90 |
Where California sits
The same service costs 8.3 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· 39th of 51
$631
AK $2,344TX $282
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.