How much rates vary
Facilitymedian $3,548 · 10th to 90th $851 to $10,471Professionalmedian $724 · 10th to 90th $562 to $2,630
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 $575.44 Median $602.56 Typical High $812.83 | Professional | None | $575.44 | $602.56 | $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 $707.95 Median $724.44 Typical High $1,862.09 | Professional | None | $707.95 | $724.44 | $1,862.09 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,162.28 Typical High $8,128.31 | Facility | None | $100.00 | $3,162.28 | $8,128.31 |
Blue Shield Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $977.24 | Professional | None | $478.63 | $691.83 | $977.24 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,148.15 | Professional | None | $707.95 | $851.14 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,162.28 Typical High $6,165.95 | Facility | None | $645.65 | $3,162.28 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,122.02 | Professional | None | $602.56 | $691.83 | $1,122.02 |
Contra Costa Health Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,047.13 | Professional | None | $602.56 | $776.25 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,621.81 | Professional | None | $660.69 | $812.83 | $1,621.81 |
Lucent Health Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
Molina Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
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 $707.95 Median $3,019.95 Typical High $6,456.54 | Facility | None | $707.95 | $3,019.95 | $6,456.54 |
Providence Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,071.52 | Professional | None | $602.56 | $691.83 | $1,071.52 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,090.30 | $10,964.78 |
United Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,148.15 | Professional | None | $524.81 | $676.08 | $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 $288.40 Median $302.00 Typical High $323.59 | Professional | 52 · Reduced service | $288.40 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $120.23 Typical High $128.82 | Professional | 53 · Discontinued | $114.82 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $457.09 Typical High $489.78 | Professional | 54 · Surgery only | $426.58 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $91.20 Typical High $97.72 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $60.26 Typical High $64.57 | Professional | 56 · Pre-op care only | $57.54 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $426.58 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $398.11 | $426.58 | $457.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,071.52 Typical High $1,737.80 | Professional | 50 · Both sides | $851.14 | $1,071.52 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $114.82 Typical High $186.21 | Professional | 80 · Assistant surgeon | $91.20 | $114.82 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $100.00 Typical High $162.18 | Professional | AS · PA/NP assist | $79.43 | $100.00 | $162.18 |
Where California sits
The same service costs 8.5 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· 42nd of 51
$724
AK $2,884TX $339
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.