How much rates vary
Facilitymedian $5,370 · 10th to 90th $977 to $12,589Professionalmedian $955 · 10th to 90th $708 to $6,166
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 $707.95 Median $758.58 Typical High $831.76 | Professional | None | $707.95 | $758.58 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,511.38 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $2,137.96 | Professional | None | $870.96 | $933.25 | $2,137.96 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,548.13 Typical High $8,912.51 | Facility | None | $100.00 | $3,548.13 | $8,912.51 |
Blue Shield Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,380.38 | Professional | None | $660.69 | $977.24 | $1,380.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $1,148.15 | Professional | None | $630.96 | $954.99 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $7,413.10 Typical High $12,589.25 | Facility | None | $645.65 | $7,413.10 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,445.44 | Professional | None | $758.58 | $912.01 | $1,445.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $426.58 Median $1,023.29 Typical High $1,288.25 | Professional | None | $426.58 | $1,023.29 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $2,089.30 | Professional | None | $831.76 | $1,047.13 | $2,089.30 |
Lucent Health Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $7,244.36 | Professional | None | $6,165.95 | $6,165.95 | $7,244.36 |
Molina Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $6,309.57 Typical High $11,481.54 | Facility | None | $758.58 | $6,309.57 | $11,481.54 |
Providence Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,412.54 | Professional | None | $758.58 | $912.01 | $1,412.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
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 $645.65 Median $851.14 Typical High $1,412.54 | Professional | None | $645.65 | $851.14 | $1,412.54 |
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 $354.81 Median $380.19 Typical High $416.87 | Professional | 52 · Reduced service | $354.81 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $151.36 Typical High $165.96 | Professional | 53 · Discontinued | $141.25 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $562.34 Typical High $616.60 | Professional | 54 · Surgery only | $524.81 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $123.03 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $75.86 Typical High $83.18 | Professional | 56 · Pre-op care only | $70.79 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $524.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $489.78 | $524.81 | $575.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $524.81 Typical High $912.01 | Professional | 62 · Two surgeons | $407.38 | $524.81 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $131.83 Typical High $234.42 | Professional | 80 · Assistant surgeon | $102.33 | $131.83 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $117.49 Typical High $204.17 | Professional | AS · PA/NP assist | $91.20 | $117.49 | $204.17 |
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· 34th of 51
$977
AK $3,548TX $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.