How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,023 to $13,804Professionalmedian $912 · 10th to 90th $692 to $6,026
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 $7,585.78 Typical High $18,197.01 | Facility | None | $2,238.72 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $794.33 | Professional | None | $707.95 | $741.31 | $794.33 |
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 $891.25 Median $912.01 Typical High $2,238.72 | Professional | None | $891.25 | $912.01 | $2,238.72 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,238.72 Typical High $10,715.19 | Facility | None | $100.00 | $2,238.72 | $10,715.19 |
Blue Shield Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,230.27 | Professional | None | $602.56 | $891.25 | $1,230.27 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,230.27 | Professional | None | $812.83 | $1,023.29 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,370.32 Typical High $10,232.93 | Facility | None | $758.58 | $5,370.32 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $1,348.96 | Professional | None | $776.25 | $851.14 | $1,348.96 |
Contra Costa Health Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,230.27 | Professional | None | $645.65 | $912.01 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,905.46 | Professional | None | $776.25 | $954.99 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,760.83 | Professional | None | $6,025.60 | $6,025.60 | $6,760.83 |
Molina Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $794.33 Median $5,011.87 Typical High $10,232.93 | Facility | None | $794.33 | $5,011.87 | $10,232.93 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,288.25 | Professional | None | $776.25 | $831.76 | $1,288.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,754.40 | $17,378.01 |
United Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,380.38 | Professional | None | $645.65 | $812.83 | $1,380.38 |
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 $346.74 Median $371.54 Typical High $398.11 | Professional | 52 · Reduced service | $346.74 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $147.91 Typical High $158.49 | Professional | 53 · Discontinued | $141.25 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $562.34 Typical High $602.56 | Professional | 54 · Surgery only | $524.81 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $112.20 Typical High $120.23 | Professional | 55 · Aftercare only | $104.71 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $79.43 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $524.81 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $489.78 | $524.81 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,288.25 Typical High $2,137.96 | Professional | 50 · Both sides | $1,023.29 | $1,288.25 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $549.54 Typical High $891.25 | Professional | 62 · Two surgeons | $426.58 | $549.54 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $138.04 Typical High $229.09 | Professional | 80 · Assistant surgeon | $109.65 | $138.04 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $120.23 Typical High $199.53 | Professional | AS · PA/NP assist | $95.50 | $120.23 | $199.53 |
Where California sits
The same service costs 7.6 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· 37th of 51
$933
AK $3,388TX $447
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.