How much rates vary
Facilitymedian $4,898 · 10th to 90th $912 to $12,589Professionalmedian $708 · 10th to 90th $525 to $4,571
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 $1,949.84 Median $7,585.78 Typical High $18,197.01 | Facility | None | $1,949.84 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $616.60 | Professional | None | $537.03 | $575.44 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,715.19 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $707.95 Typical High $1,659.59 | Professional | None | $676.08 | $707.95 | $1,659.59 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,630.27 Typical High $9,772.37 | Facility | None | $100.00 | $2,630.27 | $9,772.37 |
Blue Shield Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $933.25 | Professional | None | $457.09 | $676.08 | $933.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $933.25 | Professional | None | $616.60 | $776.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,370.32 Typical High $9,120.11 | Facility | None | $758.58 | $5,370.32 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $1,023.29 | Professional | None | $588.84 | $645.65 | $1,023.29 |
Contra Costa Health Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $933.25 | Professional | None | $489.78 | $707.95 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,445.44 | Professional | None | $602.56 | $741.31 | $1,445.44 |
Lucent Health Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $5,248.07 | Professional | None | $4,570.88 | $4,570.88 | $5,248.07 |
Molina Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $5,011.87 Typical High $9,120.11 | Facility | None | $758.58 | $5,011.87 | $9,120.11 |
Providence Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $977.24 | Professional | None | $588.84 | $645.65 | $977.24 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $11,481.54 | Facility | None | $1,258.93 | $3,090.30 | $11,481.54 |
United Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $1,023.29 | Professional | None | $489.78 | $616.60 | $1,023.29 |
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 $269.15 Median $288.40 Typical High $309.03 | Professional | 52 · Reduced service | $269.15 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $114.82 Typical High $123.03 | Professional | 53 · Discontinued | $107.15 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $426.58 Typical High $457.09 | Professional | 54 · Surgery only | $398.11 | $426.58 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $85.11 Typical High $91.20 | Professional | 55 · Aftercare only | $79.43 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $57.54 Typical High $61.66 | Professional | 56 · Pre-op care only | $53.70 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $398.11 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $371.54 | $398.11 | $426.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $977.24 Typical High $1,621.81 | Professional | 50 · Both sides | $758.58 | $977.24 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $104.71 Typical High $169.82 | Professional | 80 · Assistant surgeon | $81.28 | $104.71 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $91.20 Typical High $151.36 | Professional | AS · PA/NP assist | $70.79 | $91.20 | $151.36 |
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· 35th of 51
$724
AK $2,570TX $309
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.