How much rates vary
Facilitymedian $3,020 · 10th to 90th $832 to $10,000Professionalmedian $776 · 10th to 90th $575 to $2,884
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 $549.54 Median $575.44 Typical High $630.96 | Professional | None | $549.54 | $575.44 | $630.96 |
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 $758.58 Median $776.25 Typical High $1,949.84 | Professional | None | $758.58 | $776.25 | $1,949.84 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,089.30 Typical High $7,413.10 | Facility | None | $100.00 | $2,089.30 | $7,413.10 |
Blue Shield Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $1,071.52 | Professional | None | $524.81 | $776.25 | $1,071.52 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,445.44 | Professional | None | $707.95 | $870.96 | $1,445.44 |
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 $645.65 Median $724.44 Typical High $1,148.15 | Professional | None | $645.65 | $724.44 | $1,148.15 |
Contra Costa Health Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,047.13 | Professional | None | $758.58 | $851.14 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,659.59 | Professional | None | $676.08 | $831.76 | $1,659.59 |
Lucent Health Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Professional | None | $7,244.36 | $7,244.36 | $7,244.36 |
Molina Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $602.56 Median $2,344.23 Typical High $5,495.41 | Facility | None | $602.56 | $2,344.23 | $5,495.41 |
Providence Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $1,096.48 | Professional | None | $645.65 | $724.44 | $1,096.48 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
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 $549.54 Median $691.83 Typical High $1,174.90 | Professional | None | $549.54 | $691.83 | $1,174.90 |
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 $275.42 Median $288.40 Typical High $309.03 | Professional | 52 · Reduced service | $275.42 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $114.82 Typical High $123.03 | Professional | 53 · Discontinued | $109.65 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $436.52 Typical High $457.09 | Professional | 54 · Surgery only | $407.38 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $87.10 Typical High $91.20 | Professional | 55 · Aftercare only | $81.28 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $57.54 Typical High $61.66 | Professional | 56 · Pre-op care only | $54.95 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $407.38 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $380.19 | $407.38 | $426.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,096.48 Typical High $1,862.09 | Professional | 50 · Both sides | $870.96 | $1,096.48 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $117.49 Typical High $218.78 | Professional | 80 · Assistant surgeon | $93.33 | $117.49 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $102.33 Typical High $173.78 | Professional | AS · PA/NP assist | $81.28 | $102.33 | $173.78 |
Where California sits
The same service costs 16.2 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· 39th of 51
$776
AK $2,884TX $178
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.