How much rates vary
Facilitymedian $3,090 · 10th to 90th $832 to $10,965Professionalmedian $759 · 10th to 90th $550 to $5,012
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 $537.03 Median $575.44 Typical High $630.96 | Professional | None | $537.03 | $575.44 | $630.96 |
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 $676.08 Median $724.44 Typical High $1,659.59 | Professional | None | $676.08 | $724.44 | $1,659.59 |
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 $616.60 Median $912.01 Typical High $1,258.93 | Professional | None | $616.60 | $912.01 | $1,258.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $794.33 | Professional | None | $549.54 | $758.58 | $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 $602.56 Median $741.31 Typical High $1,174.90 | Professional | None | $602.56 | $741.31 | $1,174.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $851.14 | Professional | None | $426.58 | $676.08 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,412.54 | Professional | None | $575.44 | $707.95 | $1,412.54 |
Lucent Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,011.87 | $5,495.41 | $5,495.41 |
Molina Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
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 $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 $562.34 Median $724.44 Typical High $1,096.48 | Professional | None | $562.34 | $724.44 | $1,096.48 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
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 $467.74 Median $630.96 Typical High $1,000.00 | Professional | None | $467.74 | $630.96 | $1,000.00 |
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 $269.15 Median $288.40 Typical High $309.03 | Professional | 52 · Reduced service | $269.15 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $114.82 Typical High $125.89 | Professional | 53 · Discontinued | $107.15 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $436.52 Typical High $467.74 | Professional | 54 · Surgery only | $407.38 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $87.10 Typical High $93.33 | Professional | 55 · Aftercare only | $81.28 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $57.54 Typical High $63.10 | Professional | 56 · Pre-op care only | $53.70 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $407.38 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $380.19 | $407.38 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $977.24 Typical High $1,659.59 | Professional | 50 · Both sides | $776.25 | $977.24 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $104.71 Typical High $177.83 | Professional | 80 · Assistant surgeon | $83.18 | $104.71 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $91.20 Typical High $154.88 | Professional | AS · PA/NP assist | $72.44 | $91.20 | $154.88 |
Where California sits
The same service costs 7.4 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· 29th of 51
$832
AK $2,455TX $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.