How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,000 to $10,471Professionalmedian $1,122 · 10th to 90th $794 to $7,413
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 $912.01 Median $977.24 Typical High $1,412.54 | Professional | None | $912.01 | $977.24 | $1,412.54 |
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 $1,047.13 Median $1,258.93 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,258.93 | $2,454.71 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $7,585.78 | Facility | None | $100.00 | $2,137.96 | $7,585.78 |
Blue Shield Setting Professional Modifier None Typical Low $616.60 Median $891.25 Typical High $1,258.93 | Professional | None | $616.60 | $891.25 | $1,258.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,380.38 | Professional | None | $933.25 | $1,122.02 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,511.89 Typical High $5,011.87 | Facility | None | $645.65 | $2,511.89 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,621.81 | Professional | None | $851.14 | $1,023.29 | $1,621.81 |
Contra Costa Health Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,380.38 | Professional | None | $724.44 | $1,023.29 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $2,290.87 | Professional | None | $851.14 | $1,096.48 | $2,290.87 |
Lucent Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,585.78 | Professional | None | $7,413.10 | $7,413.10 | $7,585.78 |
Molina Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $758.58 Median $2,511.89 Typical High $6,025.60 | Facility | None | $758.58 | $2,511.89 | $6,025.60 |
Providence Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,584.89 | Professional | None | $831.76 | $1,023.29 | $1,584.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,365.16 | $14,454.40 |
United Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,659.59 | Professional | None | $758.58 | $977.24 | $1,659.59 |
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 $467.74 Median $489.78 Typical High $524.81 | Professional | 52 · Reduced service | $467.74 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $208.93 | Professional | 53 · Discontinued | $186.21 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $741.31 Typical High $776.25 | Professional | 54 · Surgery only | $707.95 | $741.31 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $147.91 Typical High $154.88 | Professional | 55 · Aftercare only | $141.25 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $97.72 Typical High $104.71 | Professional | 56 · Pre-op care only | $93.33 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $691.83 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $660.69 | $691.83 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,584.89 Typical High $2,630.27 | Professional | 50 · Both sides | $1,258.93 | $1,584.89 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $169.82 Typical High $281.84 | Professional | 80 · Assistant surgeon | $134.90 | $169.82 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $147.91 Typical High $245.47 | Professional | AS · PA/NP assist | $117.49 | $147.91 | $245.47 |
Where California sits
The same service costs 7.6 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· 32nd of 51
$1,259
AK $3,981TX $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.