How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,230 to $19,498Professionalmedian $1,202 · 10th to 90th $871 to $7,943
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 $891.25 Median $954.99 Typical High $1,023.29 | Professional | None | $891.25 | $954.99 | $1,023.29 |
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 $1,148.15 Median $1,202.26 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,202.26 | $2,238.72 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $3,630.78 Typical High $14,454.40 | Facility | None | $91.20 | $3,630.78 | $14,454.40 |
Blue Shield Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,548.82 | Professional | None | $794.33 | $1,148.15 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $12,882.50 Typical High $23,442.29 | Facility | None | $758.58 | $12,882.50 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,659.59 | Professional | None | $977.24 | $1,096.48 | $1,659.59 |
Contra Costa Health Setting Professional Modifier None Typical Low $12,882.50 Median $12,882.50 Typical High $13,803.84 | Professional | None | $12,882.50 | $12,882.50 | $13,803.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $3,388.44 Typical High $6,309.57 | Professional | None | $630.96 | $3,388.44 | $6,309.57 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $9,332.54 | Professional | None | $7,943.28 | $7,943.28 | $9,332.54 |
Molina Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $12,589.25 Typical High $22,387.21 | Facility | None | $831.76 | $12,589.25 | $22,387.21 |
Providence Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,659.59 | Professional | None | $977.24 | $1,096.48 | $1,659.59 |
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 $794.33 Median $1,071.52 Typical High $1,995.26 | Professional | None | $794.33 | $1,071.52 | $1,995.26 |
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 $446.68 Median $478.63 Typical High $512.86 | Professional | 52 · Reduced service | $446.68 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $204.17 | Professional | 53 · Discontinued | $177.83 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $676.08 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $151.36 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $102.33 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $630.96 | $660.69 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,659.59 Typical High $2,137.96 | Professional | 50 · Both sides | $1,318.26 | $1,659.59 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $177.83 Typical High $229.09 | Professional | 80 · Assistant surgeon | $141.25 | $177.83 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $154.88 Typical High $199.53 | Professional | AS · PA/NP assist | $123.03 | $154.88 | $199.53 |
Where California sits
The same service costs 46.8 times more in Alaska than in Hawaii. 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· 45th of 51
$1,202
AK $4,467HI $95.50
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.