How much rates vary
Facilitymedian $5,129 · 10th to 90th $912 to $12,303Professionalmedian $851 · 10th to 90th $631 to $5,623
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 $645.65 Median $676.08 Typical High $724.44 | Professional | None | $645.65 | $676.08 | $724.44 |
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 $812.83 Median $851.14 Typical High $2,041.74 | Professional | None | $812.83 | $851.14 | $2,041.74 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,162.28 Typical High $8,912.51 | Facility | None | $100.00 | $3,162.28 | $8,912.51 |
Blue Shield Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $1,122.02 | Professional | None | $549.54 | $812.83 | $1,122.02 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,202.26 | Professional | None | $741.31 | $912.01 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,370.32 Typical High $10,232.93 | Facility | None | $645.65 | $5,370.32 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,202.26 | Professional | None | $707.95 | $776.25 | $1,202.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,096.48 | Professional | None | $630.96 | $812.83 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,737.80 | Professional | None | $691.83 | $851.14 | $1,737.80 |
Lucent Health Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,165.95 | Professional | None | $5,623.41 | $5,623.41 | $6,165.95 |
Molina Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $741.31 Median $4,897.79 Typical High $10,232.93 | Facility | None | $741.31 | $4,897.79 | $10,232.93 |
Providence Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,174.90 | Professional | None | $707.95 | $758.58 | $1,174.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,754.40 | $17,378.01 |
United Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,230.27 | Professional | None | $588.84 | $741.31 | $1,230.27 |
10 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 $323.59 Median $338.84 Typical High $363.08 | Professional | 52 · Reduced service | $323.59 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $144.54 | Professional | 53 · Discontinued | $128.82 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $512.86 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $512.86 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $72.44 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $478.63 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $478.63 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,174.90 Typical High $2,041.74 | Professional | 50 · Both sides | $912.01 | $1,174.90 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $489.78 Typical High $851.14 | Professional | 62 · Two surgeons | $389.05 | $489.78 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $128.82 Typical High $223.87 | Professional | 80 · Assistant surgeon | $104.71 | $128.82 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $109.65 Typical High $190.55 | Professional | AS · PA/NP assist | $85.11 | $109.65 | $190.55 |
Where California sits
The same service costs 5.8 times more in Colorado than in Hawaii. 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.
Physician feeFacility fee
CO $13,930HI $2,400
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.