How much rates vary
Facilitymedian $3,548 · 10th to 90th $955 to $10,965Professionalmedian $933 · 10th to 90th $692 to $6,026
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 $691.83 Median $741.31 Typical High $812.83 | Professional | None | $691.83 | $741.31 | $812.83 |
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 $851.14 Median $891.25 Typical High $2,238.72 | Professional | None | $851.14 | $891.25 | $2,238.72 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,467.37 Typical High $8,128.31 | Facility | None | $100.00 | $3,467.37 | $8,128.31 |
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 $758.58 Median $1,096.48 Typical High $1,148.15 | Professional | None | $758.58 | $1,096.48 | $1,148.15 |
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 $724.44 Median $870.96 Typical High $1,380.38 | Professional | None | $724.44 | $870.96 | $1,380.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $501.19 Median $1,023.29 Typical High $1,258.93 | Professional | None | $501.19 | $1,023.29 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $2,041.74 | Professional | None | $812.83 | $1,047.13 | $2,041.74 |
Lucent Health Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $7,244.36 | Professional | None | $6,025.60 | $6,025.60 | $7,244.36 |
Molina Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $2,511.89 Typical High $6,025.60 | Facility | None | $758.58 | $2,511.89 | $6,025.60 |
Providence Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,380.38 | Professional | None | $724.44 | $870.96 | $1,380.38 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
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 $630.96 Median $831.76 Typical High $1,380.38 | Professional | None | $630.96 | $831.76 | $1,380.38 |
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 $346.74 Median $371.54 Typical High $407.38 | Professional | 52 · Reduced service | $346.74 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $147.91 Typical High $162.18 | Professional | 53 · Discontinued | $138.04 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $549.54 Typical High $602.56 | Professional | 54 · Surgery only | $512.86 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $81.28 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $478.63 | $512.86 | $562.34 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $512.86 Typical High $891.25 | Professional | 62 · Two surgeons | $398.11 | $512.86 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $128.82 Typical High $229.09 | Professional | 80 · Assistant surgeon | $100.00 | $128.82 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $114.82 Typical High $199.53 | Professional | AS · PA/NP assist | $87.10 | $114.82 | $199.53 |
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· 35th of 51
$955
AK $3,467TX $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.