How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,230 to $15,136Professionalmedian $1,585 · 10th to 90th $1,148 to $5,370
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 $2,570.40 Median $8,912.51 Typical High $19,054.61 | Facility | None | $2,570.40 | $8,912.51 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $1,348.96 | Professional | None | $1,202.26 | $1,258.93 | $1,348.96 |
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 $1,513.56 Median $1,584.89 Typical High $3,630.78 | Professional | None | $1,513.56 | $1,584.89 | $3,630.78 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $2,089.30 Typical High $7,585.78 | Facility | None | $91.20 | $2,089.30 | $7,585.78 |
Blue Shield Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $1,949.84 | Professional | None | $954.99 | $1,380.38 | $1,949.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $6,456.54 Typical High $11,481.54 | Facility | None | $794.33 | $6,456.54 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,258.93 | $1,445.44 | $2,238.72 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,584.89 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $3,162.28 | Professional | None | $1,202.26 | $1,513.56 | $3,162.28 |
Lucent Health Setting Professional Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $11,220.18 | Professional | None | $11,220.18 | $11,220.18 | $11,220.18 |
Molina Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $851.14 Median $6,165.95 Typical High $10,964.78 | Facility | None | $851.14 | $6,165.95 | $10,964.78 |
Providence Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,412.54 | $2,187.76 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
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 $1,096.48 Median $1,348.96 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,348.96 | $2,290.87 |
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 $602.56 Median $630.96 Typical High $676.08 | Professional | 52 · Reduced service | $602.56 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $257.04 Typical High $269.15 | Professional | 53 · Discontinued | $239.88 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $954.99 Typical High $1,000.00 | Professional | 54 · Surgery only | $891.25 | $954.99 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $204.17 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $125.89 Typical High $134.90 | Professional | 56 · Pre-op care only | $120.23 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $891.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $831.76 | $891.25 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $234.42 Typical High $389.05 | Professional | 80 · Assistant surgeon | $186.21 | $234.42 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $204.17 Typical High $338.84 | Professional | AS · PA/NP assist | $162.18 | $204.17 | $338.84 |
Where California sits
The same service costs 18.6 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· 38th of 51
$1,585
AK $5,623TX $302
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.