How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,122 to $15,488Professionalmedian $1,096 · 10th to 90th $813 to $7,079
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 $812.83 Median $870.96 Typical High $912.01 | Professional | None | $812.83 | $870.96 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $11,748.98 Typical High $20,417.38 | Facility | None | $5,888.44 | $11,748.98 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $2,511.89 | Professional | None | $1,023.29 | $1,096.48 | $2,511.89 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,089.30 Typical High $11,748.98 | Facility | None | $100.00 | $2,089.30 | $11,748.98 |
Blue Shield Setting Professional Modifier None Typical Low $707.95 Median $1,047.13 Typical High $1,445.44 | Professional | None | $707.95 | $1,047.13 | $1,445.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,348.96 | Professional | None | $912.01 | $1,122.02 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $6,918.31 Typical High $11,481.54 | Facility | None | $851.14 | $6,918.31 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,513.56 | Professional | None | $891.25 | $977.24 | $1,513.56 |
Contra Costa Health Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,348.96 | Professional | None | $724.44 | $1,000.00 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $2,187.76 | Professional | None | $831.76 | $1,047.13 | $2,187.76 |
Lucent Health Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,585.78 | Professional | None | $7,079.46 | $7,079.46 | $7,585.78 |
Molina Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
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 $870.96 Median $6,456.54 Typical High $11,220.18 | Facility | None | $870.96 | $6,456.54 | $11,220.18 |
Providence Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,479.11 | Professional | None | $891.25 | $977.24 | $1,479.11 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,918.31 Typical High $18,620.87 | Facility | None | $2,884.03 | $6,918.31 | $18,620.87 |
United Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,548.82 | Professional | None | $741.31 | $933.25 | $1,548.82 |
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 $407.38 Median $436.52 Typical High $457.09 | Professional | 52 · Reduced service | $407.38 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $173.78 Typical High $186.21 | Professional | 53 · Discontinued | $162.18 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $645.65 Typical High $691.83 | Professional | 54 · Surgery only | $616.60 | $645.65 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $128.82 Typical High $138.04 | Professional | 55 · Aftercare only | $123.03 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $87.10 Typical High $93.33 | Professional | 56 · Pre-op care only | $81.28 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,479.11 Typical High $2,454.71 | Professional | 50 · Both sides | $1,174.90 | $1,479.11 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $616.60 Typical High $1,023.29 | Professional | 62 · Two surgeons | $489.78 | $616.60 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $158.49 Typical High $263.03 | Professional | 80 · Assistant surgeon | $125.89 | $158.49 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $138.04 Typical High $245.47 | Professional | AS · PA/NP assist | $109.65 | $138.04 | $245.47 |
Where California sits
The same service costs 7.9 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
$1,096
AK $3,890TX $490
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.