How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,023 to $12,589Professionalmedian $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 $912.01 Median $954.99 Typical High $1,023.29 | Professional | None | $912.01 | $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 $1,096.48 Median $1,202.26 Typical High $2,754.23 | Professional | None | $1,096.48 | $1,202.26 | $2,754.23 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,162.28 Typical High $8,317.64 | Facility | None | $100.00 | $3,162.28 | $8,317.64 |
Blue Shield Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $1,698.24 | Professional | None | $831.76 | $1,230.27 | $1,698.24 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,230.27 | Professional | None | $870.96 | $1,202.26 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,370.32 Typical High $9,120.11 | Facility | None | $645.65 | $5,370.32 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,819.70 | Professional | None | $977.24 | $1,174.90 | $1,819.70 |
Contra Costa Health Setting Professional Modifier None Typical Low $645.65 Median $1,071.52 Typical High $1,348.96 | Professional | None | $645.65 | $1,071.52 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $2,344.23 | Professional | None | $891.25 | $1,122.02 | $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 $4,897.79 Typical High $8,912.51 | Facility | None | $758.58 | $4,897.79 | $8,912.51 |
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 $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 $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 $181.97 Median $190.55 Typical High $204.17 | Professional | 53 · Discontinued | $181.97 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $724.44 Typical High $776.25 | Professional | 54 · Surgery only | $676.08 | $724.44 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $154.88 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $95.50 Typical High $102.33 | Professional | 56 · Pre-op care only | $91.20 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $676.08 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $630.96 | $676.08 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,548.82 Typical High $2,630.27 | Professional | 50 · Both sides | $1,202.26 | $1,548.82 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $165.96 Typical High $281.84 | Professional | 80 · Assistant surgeon | $128.82 | $165.96 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $144.54 Typical High $245.47 | Professional | AS · PA/NP assist | $112.20 | $144.54 | $245.47 |
Where California sits
The same service costs 8.3 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· 34th of 51
$1,230
AK $4,169TX $501
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.