How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,175 to $15,136Professionalmedian $1,259 · 10th to 90th $933 to $8,913
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 $954.99 Median $1,023.29 Typical High $1,096.48 | Professional | None | $954.99 | $1,023.29 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $11,481.54 Typical High $21,379.62 | Facility | None | $5,370.32 | $11,481.54 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,288.25 | $2,884.03 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $2,041.74 Typical High $5,495.41 | Facility | None | $91.20 | $2,041.74 | $5,495.41 |
Blue Shield Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,513.56 | Professional | None | $741.31 | $1,096.48 | $1,513.56 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,318.26 | $1,698.24 |
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 $1,000.00 Median $1,148.15 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,148.15 | $1,819.70 |
Contra Costa Health Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,584.89 | Professional | None | $891.25 | $1,174.90 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,570.40 | Professional | None | $977.24 | $1,258.93 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
Molina Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $6,165.95 Typical High $10,964.78 | Facility | None | $870.96 | $6,165.95 | $10,964.78 |
Providence Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,122.02 | $1,737.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
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 $851.14 Median $1,096.48 Typical High $1,819.70 | Professional | None | $851.14 | $1,096.48 | $1,819.70 |
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 $478.63 Median $512.86 Typical High $549.54 | Professional | 52 · Reduced service | $478.63 | $512.86 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $218.78 | Professional | 53 · Discontinued | $190.55 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $812.83 | Professional | 54 · Surgery only | $724.44 | $758.58 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $154.88 Typical High $162.18 | Professional | 55 · Aftercare only | $144.54 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $109.65 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $758.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,737.80 Typical High $2,818.38 | Professional | 50 · Both sides | $1,412.54 | $1,737.80 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $186.21 Typical High $302.00 | Professional | 80 · Assistant surgeon | $151.36 | $186.21 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $162.18 Typical High $263.03 | Professional | AS · PA/NP assist | $131.83 | $162.18 | $263.03 |
Where California sits
The same service costs 8.7 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· 36th of 51
$1,288
AK $4,571TX $525
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.