How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,047 to $11,482Professionalmedian $1,202 · 10th to 90th $891 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 $2,238.72 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 $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 $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 $1,047.13 Median $1,202.26 Typical High $2,754.23 | Professional | None | $1,047.13 | $1,202.26 | $2,754.23 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,162.28 Typical High $8,709.64 | Facility | None | $100.00 | $3,162.28 | $8,709.64 |
Blue Shield Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,819.70 | Professional | None | $891.25 | $1,318.26 | $1,819.70 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,202.26 | Professional | None | $758.58 | $1,096.48 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,511.89 Typical High $5,128.61 | Facility | None | $645.65 | $2,511.89 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,819.70 | Professional | None | $954.99 | $1,148.15 | $1,819.70 |
Contra Costa Health Setting Professional Modifier None Typical Low $501.19 Median $1,096.48 Typical High $1,348.96 | Professional | None | $501.19 | $1,096.48 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $2,344.23 | Professional | None | $891.25 | $1,148.15 | $2,344.23 |
Lucent Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $8,128.31 | Professional | None | $7,413.10 | $7,413.10 | $8,128.31 |
Molina Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
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 $2,511.89 Typical High $6,165.95 | Facility | None | $758.58 | $2,511.89 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,659.59 | Professional | None | $954.99 | $1,148.15 | $1,659.59 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,495.41 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,495.41 | $17,378.01 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,659.59 | Professional | None | $794.33 | $1,047.13 | $1,659.59 |
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 $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $134.90 | $141.25 | $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 $1,230.27 Median $1,584.89 Typical High $2,570.40 | Professional | 50 · Both sides | $1,230.27 | $1,584.89 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $165.96 Typical High $275.42 | Professional | 80 · Assistant surgeon | $131.83 | $165.96 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $147.91 Typical High $239.88 | Professional | AS · PA/NP assist | $114.82 | $147.91 | $239.88 |
Where California sits
The same service costs 8.9 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
$1,288
AK $4,169TX $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.