How much rates vary
Facilitymedian $3,548 · 10th to 90th $794 to $11,482Professionalmedian $708 · 10th to 90th $490 to $5,129
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 $1,905.46 Median $6,165.95 Typical High $15,848.93 | Facility | None | $1,905.46 | $6,165.95 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $602.56 | Professional | None | $512.86 | $562.34 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,606.93 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $1,862.09 | Professional | None | $549.54 | $707.95 | $1,862.09 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,511.89 Typical High $7,943.28 | Facility | None | $100.00 | $2,511.89 | $7,943.28 |
Blue Shield Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $977.24 | Professional | None | $478.63 | $707.95 | $977.24 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $1,862.09 | Professional | None | $524.81 | $645.65 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,454.71 Typical High $5,011.87 | Facility | None | $575.44 | $2,454.71 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $1,230.27 | Professional | None | $537.03 | $707.95 | $1,230.27 |
Contra Costa Health Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $1,230.27 | Professional | None | $575.44 | $630.96 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $1,230.27 | Professional | None | $501.19 | $616.60 | $1,230.27 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $6,606.93 Typical High $6,606.93 | Professional | None | $5,128.61 | $6,606.93 | $6,606.93 |
Molina Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
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 $616.60 Median $2,344.23 Typical High $5,495.41 | Facility | None | $616.60 | $2,344.23 | $5,495.41 |
Providence Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $1,174.90 | Professional | None | $501.19 | $707.95 | $1,174.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,606.93 Typical High $18,620.87 | Facility | None | $2,884.03 | $6,606.93 | $18,620.87 |
United Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $912.01 | Professional | None | $416.87 | $562.34 | $912.01 |
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 $257.04 Median $281.84 Typical High $302.00 | Professional | 52 · Reduced service | $257.04 | $281.84 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $112.20 Typical High $120.23 | Professional | 53 · Discontinued | $102.33 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $380.19 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $56.23 Typical High $60.26 | Professional | 56 · Pre-op care only | $51.29 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $426.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $87.10 Typical High $177.83 | Professional | 80 · Assistant surgeon | $70.79 | $87.10 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $77.62 Typical High $154.88 | Professional | AS · PA/NP assist | $61.66 | $77.62 | $154.88 |
Where California sits
The same service costs 6.6 times more in Alaska than in Utah. 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· 29th of 51
$759
AK $2,188UT $331
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.