How much rates vary
Facilitymedian $2,291 · 10th to 90th $676 to $7,244Professionalmedian $457 · 10th to 90th $347 to $3,162
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 $354.81 Median $380.19 Typical High $407.38 | Professional | None | $354.81 | $380.19 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,128.61 Typical High $10,471.29 | Facility | None | $2,137.96 | $5,128.61 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,096.48 | Professional | None | $457.09 | $457.09 | $1,096.48 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,238.72 Typical High $5,754.40 | Facility | None | $100.00 | $2,238.72 | $5,754.40 |
Blue Shield Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $588.84 | Professional | None | $288.40 | $426.58 | $588.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $707.95 | Professional | None | $446.68 | $549.54 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $2,398.83 Typical High $4,786.30 | Facility | None | $426.58 | $2,398.83 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $691.83 | Professional | None | $371.54 | $436.52 | $691.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $660.69 | Professional | None | $371.54 | $489.78 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $1,000.00 | Professional | None | $416.87 | $512.86 | $1,000.00 |
Lucent Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,548.13 | Professional | None | $3,162.28 | $3,162.28 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
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 $478.63 Median $2,290.87 Typical High $4,786.30 | Facility | None | $478.63 | $2,290.87 | $4,786.30 |
Providence Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $660.69 | Professional | None | $371.54 | $416.87 | $660.69 |
Sutter Health Plus 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 |
United Setting Facility Modifier None Typical Low $676.08 Median $933.25 Typical High $7,585.78 | Facility | None | $676.08 | $933.25 | $7,585.78 |
United Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $691.83 | Professional | None | $323.59 | $416.87 | $691.83 |
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 $177.83 Median $190.55 Typical High $204.17 | Professional | 52 · Reduced service | $177.83 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $75.86 Typical High $81.28 | Professional | 53 · Discontinued | $70.79 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $281.84 Typical High $309.03 | Professional | 54 · Surgery only | $263.03 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $56.23 Typical High $61.66 | Professional | 55 · Aftercare only | $52.48 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.02 Typical High $40.74 | Professional | 56 · Pre-op care only | $35.48 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $263.03 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $245.47 | $263.03 | $288.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $645.65 Typical High $1,071.52 | Professional | 50 · Both sides | $501.19 | $645.65 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $208.93 Median $269.15 Typical High $446.68 | Professional | 62 · Two surgeons | $208.93 | $269.15 | $446.68 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $69.18 Typical High $117.49 | Professional | 80 · Assistant surgeon | $53.70 | $69.18 | $117.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $60.26 Typical High $100.00 | Professional | AS · PA/NP assist | $46.77 | $60.26 | $100.00 |
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
$468
AK $1,738TX $209
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.