How much rates vary
Facilitymedian $3,090 · 10th to 90th $832 to $10,965Professionalmedian $692 · 10th to 90th $513 to $4,677
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 $2,238.72 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,238.72 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $602.56 | Professional | None | $524.81 | $562.34 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,128.31 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $1,548.82 | Professional | None | $660.69 | $691.83 | $1,548.82 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $7,585.78 | Facility | None | $100.00 | $2,137.96 | $7,585.78 |
Blue Shield Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $870.96 | Professional | None | $426.58 | $630.96 | $870.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $794.33 | Professional | None | $562.34 | $776.25 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,511.89 Typical High $5,011.87 | Facility | None | $645.65 | $2,511.89 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,023.29 | Professional | None | $549.54 | $645.65 | $1,023.29 |
Contra Costa Health Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $870.96 | Professional | None | $426.58 | $691.83 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,445.44 | Professional | None | $602.56 | $724.44 | $1,445.44 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,128.61 | Professional | None | $4,677.35 | $4,677.35 | $5,128.61 |
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 $707.95 Median $2,511.89 Typical High $5,888.44 | Facility | None | $707.95 | $2,511.89 | $5,888.44 |
Providence Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $977.24 | Professional | None | $549.54 | $630.96 | $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 $1,659.59 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 $478.63 Median $616.60 Typical High $1,023.29 | Professional | None | $478.63 | $616.60 | $1,023.29 |
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 $263.03 Median $281.84 Typical High $302.00 | Professional | 52 · Reduced service | $263.03 | $281.84 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $112.20 Typical High $120.23 | Professional | 53 · Discontinued | $104.71 | $112.20 | $120.23 |
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 $52.48 Median $56.23 Typical High $60.26 | Professional | 56 · Pre-op care only | $52.48 | $56.23 | $60.26 |
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 $741.31 Median $933.25 Typical High $1,584.89 | Professional | 50 · Both sides | $741.31 | $933.25 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $398.11 Typical High $676.08 | Professional | 62 · Two surgeons | $309.03 | $398.11 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $100.00 Typical High $173.78 | Professional | 80 · Assistant surgeon | $79.43 | $100.00 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $87.10 Typical High $147.91 | Professional | AS · PA/NP assist | $69.18 | $87.10 | $147.91 |
Where California sits
The same service costs 7.8 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
$692
AK $2,570TX $331
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.