How much rates vary
Facilitymedian $5,129 · 10th to 90th $955 to $15,136Professionalmedian $851 · 10th to 90th $646 to $5,495
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 $933.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $707.95 | Professional | None | $616.60 | $660.69 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $13,182.57 Typical High $23,442.29 | Facility | None | $5,370.32 | $13,182.57 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,905.46 | Professional | None | $758.58 | $831.76 | $1,905.46 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $2,041.74 Typical High $6,760.83 | Facility | None | $95.50 | $2,041.74 | $6,760.83 |
Blue Shield Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $1,318.26 | Professional | None | $645.65 | $954.99 | $1,318.26 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $851.14 | Professional | None | $588.84 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $5,495.41 Typical High $9,120.11 | Facility | None | $776.25 | $5,495.41 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,288.25 | Professional | None | $676.08 | $812.83 | $1,288.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $389.05 Median $758.58 Typical High $954.99 | Professional | None | $389.05 | $758.58 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,621.81 | Professional | None | $630.96 | $812.83 | $1,621.81 |
Lucent Health Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,754.40 | Professional | None | $5,495.41 | $5,495.41 | $5,754.40 |
Molina Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $776.25 Median $5,128.61 Typical High $8,709.64 | Facility | None | $776.25 | $5,128.61 | $8,709.64 |
Providence Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,230.27 | Professional | None | $660.69 | $812.83 | $1,230.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $18,620.87 | Facility | None | $2,884.03 | $6,760.83 | $18,620.87 |
United Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,148.15 | Professional | None | $549.54 | $724.44 | $1,148.15 |
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 $309.03 Median $331.13 Typical High $354.81 | Professional | 52 · Reduced service | $309.03 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $131.83 Typical High $141.25 | Professional | 53 · Discontinued | $125.89 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $501.19 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $66.07 Typical High $70.79 | Professional | 56 · Pre-op care only | $61.66 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $467.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $436.52 | $467.74 | $501.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,096.48 Typical High $1,862.09 | Professional | 50 · Both sides | $870.96 | $1,096.48 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $117.49 Typical High $199.53 | Professional | 80 · Assistant surgeon | $91.20 | $117.49 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $102.33 Typical High $173.78 | Professional | AS · PA/NP assist | $81.28 | $102.33 | $173.78 |
Where California sits
The same service costs 8.7 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· 31st of 51
$912
AK $2,884TX $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.