How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,000 to $16,982Professionalmedian $1,096 · 10th to 90th $851 to $7,413
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 $2,137.96 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,137.96 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $933.25 | Professional | None | $812.83 | $870.96 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,715.19 Typical High $19,498.45 | Facility | None | $5,248.07 | $10,715.19 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $2,454.71 | Professional | None | $1,000.00 | $1,096.48 | $2,454.71 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,238.72 Typical High $9,549.93 | Facility | None | $100.00 | $2,238.72 | $9,549.93 |
Blue Shield Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $1,737.80 | Professional | None | $851.14 | $1,258.93 | $1,737.80 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,122.02 | Professional | None | $794.33 | $1,096.48 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $10,000.00 Typical High $19,054.61 | Facility | None | $645.65 | $10,000.00 | $19,054.61 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,659.59 | Professional | None | $891.25 | $1,071.52 | $1,659.59 |
Contra Costa Health Setting Professional Modifier None Typical Low $588.84 Median $977.24 Typical High $1,230.27 | Professional | None | $588.84 | $977.24 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $2,089.30 | Professional | None | $812.83 | $1,047.13 | $2,089.30 |
Lucent Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | None | $7,413.10 | $7,413.10 | $7,413.10 |
Molina Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $758.58 Median $7,762.47 Typical High $17,782.79 | Facility | None | $758.58 | $7,762.47 | $17,782.79 |
Providence Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,584.89 | Professional | None | $851.14 | $1,071.52 | $1,584.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $17,782.79 | Facility | None | $2,290.87 | $5,754.40 | $17,782.79 |
United Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,513.56 | Professional | None | $707.95 | $954.99 | $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 $407.38 Median $436.52 Typical High $467.74 | Professional | 52 · Reduced service | $407.38 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $173.78 Typical High $186.21 | Professional | 53 · Discontinued | $162.18 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $645.65 Typical High $691.83 | Professional | 54 · Surgery only | $616.60 | $645.65 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $128.82 Typical High $138.04 | Professional | 55 · Aftercare only | $123.03 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $87.10 Typical High $93.33 | Professional | 56 · Pre-op care only | $81.28 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,412.54 Typical High $2,344.23 | Professional | 50 · Both sides | $1,122.02 | $1,412.54 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $151.36 Typical High $251.19 | Professional | 80 · Assistant surgeon | $120.23 | $151.36 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $131.83 Typical High $218.78 | Professional | AS · PA/NP assist | $104.71 | $131.83 | $218.78 |
Where California sits
The same service costs 7.9 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· 33rd of 51
$1,202
AK $3,715TX $468
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.