How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,122 to $15,136Professionalmedian $1,072 · 10th to 90th $813 to $7,943
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 $1,023.29 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,023.29 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,023.29 | Professional | None | $891.25 | $954.99 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,715.19 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $2,754.23 | Professional | None | $977.24 | $1,000.00 | $2,754.23 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,548.13 Typical High $12,302.69 | Facility | None | $100.00 | $3,548.13 | $12,302.69 |
Blue Shield Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,479.11 | Professional | None | $724.44 | $1,071.52 | $1,479.11 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,318.26 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $6,918.31 Typical High $12,589.25 | Facility | None | $758.58 | $6,918.31 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,778.28 | Professional | None | $812.83 | $1,047.13 | $1,778.28 |
Contra Costa Health Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,621.81 | Professional | None | $891.25 | $1,202.26 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,511.89 | Professional | None | $977.24 | $1,258.93 | $2,511.89 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $8,912.51 | Professional | None | $7,943.28 | $7,943.28 | $8,912.51 |
Molina Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $831.76 Median $6,456.54 Typical High $12,589.25 | Facility | None | $831.76 | $6,456.54 | $12,589.25 |
Providence Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,698.24 | Professional | None | $812.83 | $1,023.29 | $1,698.24 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
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 $812.83 Median $1,047.13 Typical High $1,778.28 | Professional | None | $812.83 | $1,047.13 | $1,778.28 |
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 $446.68 Median $478.63 Typical High $512.86 | Professional | 52 · Reduced service | $446.68 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $204.17 | Professional | 53 · Discontinued | $177.83 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $676.08 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $151.36 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $102.33 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $630.96 | $660.69 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,698.24 Typical High $2,754.23 | Professional | 50 · Both sides | $1,348.96 | $1,698.24 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $181.97 Typical High $302.00 | Professional | 80 · Assistant surgeon | $141.25 | $181.97 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $158.49 Typical High $257.04 | Professional | AS · PA/NP assist | $125.89 | $158.49 | $257.04 |
Where California sits
The same service costs 13.8 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· 41st of 51
$1,122
AK $4,467TX $324
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.