How much rates vary
Facilitymedian $2,951 · 10th to 90th $759 to $12,589Professionalmedian $1,096 · 10th to 90th $813 to $7,586
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 $2,398.83 Median $8,912.51 Typical High $19,054.61 | Facility | None | $2,398.83 | $8,912.51 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,548.82 | Professional | None | $891.25 | $1,023.29 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $11,220.18 Typical High $20,417.38 | Facility | None | $5,370.32 | $11,220.18 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $2,570.40 | Professional | None | $776.25 | $1,096.48 | $2,570.40 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,344.23 Typical High $10,000.00 | Facility | None | $100.00 | $2,344.23 | $10,000.00 |
Blue Shield Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $1,412.54 | Professional | None | $691.83 | $1,023.29 | $1,412.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,023.29 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,570.40 Typical High $4,677.35 | Facility | None | $851.14 | $2,570.40 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,698.24 | Professional | None | $891.25 | $954.99 | $1,698.24 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,230.27 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $3,019.95 | Professional | None | $933.25 | $1,174.90 | $3,019.95 |
Lucent Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $8,511.38 | Professional | None | $7,585.78 | $7,585.78 | $8,511.38 |
Molina Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $870.96 Median $2,630.27 Typical High $6,025.60 | Facility | None | $870.96 | $2,630.27 | $6,025.60 |
Providence Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,621.81 | Professional | None | $891.25 | $954.99 | $1,621.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,698.24 | Professional | None | $776.25 | $1,000.00 | $1,698.24 |
8 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 $436.52 Median $467.74 Typical High $501.19 | Professional | 52 · Reduced service | $436.52 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $93.33 Typical High $100.00 | Professional | 56 · Pre-op care only | $89.13 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $169.82 Typical High $269.15 | Professional | 80 · Assistant surgeon | $134.90 | $169.82 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $147.91 Typical High $234.42 | Professional | AS · PA/NP assist | $117.49 | $147.91 | $234.42 |
Where California sits
The same service costs 7.6 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· 37th of 51
$1,096
AK $4,266TX $562
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.