How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,047 to $18,621Professionalmedian $912 · 10th to 90th $676 to $6,761
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 $933.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $707.95 Typical High $758.58 | Professional | None | $676.08 | $707.95 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,232.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $933.25 Typical High $2,454.71 | Professional | None | $912.01 | $933.25 | $2,454.71 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $2,041.74 Typical High $5,495.41 | Facility | None | $91.20 | $2,041.74 | $5,495.41 |
Blue Shield Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $1,148.15 | Professional | None | $562.34 | $831.76 | $1,148.15 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,096.48 | Professional | None | $794.33 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $13,182.57 Typical High $23,442.29 | Facility | None | $794.33 | $13,182.57 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,513.56 | Professional | None | $741.31 | $812.83 | $1,513.56 |
Contra Costa Health Setting Professional Modifier None Typical Low $562.34 Median $977.24 Typical High $1,230.27 | Professional | None | $562.34 | $977.24 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $2,137.96 | Professional | None | $812.83 | $1,047.13 | $2,137.96 |
Lucent Health Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $7,413.10 | Professional | None | $6,760.83 | $6,760.83 | $7,413.10 |
Molina Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $831.76 Median $12,302.69 Typical High $21,877.62 | Facility | None | $831.76 | $12,302.69 | $21,877.62 |
Providence Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,445.44 | Professional | None | $741.31 | $812.83 | $1,445.44 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $20,417.38 | Facility | None | $2,884.03 | $6,760.83 | $20,417.38 |
United Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,513.56 | Professional | None | $691.83 | $891.25 | $1,513.56 |
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 $338.84 Median $354.81 Typical High $380.19 | Professional | 52 · Reduced service | $338.84 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $141.25 Typical High $151.36 | Professional | 53 · Discontinued | $134.90 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $512.86 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $102.33 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $70.79 Typical High $75.86 | Professional | 56 · Pre-op care only | $67.61 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $478.63 | $501.19 | $537.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,445.44 Typical High $2,238.72 | Professional | 50 · Both sides | $1,148.15 | $1,445.44 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $154.88 Typical High $239.88 | Professional | 80 · Assistant surgeon | $123.03 | $154.88 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $134.90 Typical High $208.93 | Professional | AS · PA/NP assist | $107.15 | $134.90 | $208.93 |
Where California sits
The same service costs 16.2 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· 42nd of 51
$933
AK $3,802TX $234
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.