How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,259 to $13,490Professionalmedian $1,514 · 10th to 90th $1,072 to $8,318
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 $7,585.78 Typical High $18,197.01 | Facility | None | $2,238.72 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,230.27 | $1,258.93 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,232.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $4,786.30 | Professional | None | $1,258.93 | $1,584.89 | $4,786.30 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,570.40 Typical High $10,232.93 | Facility | None | $100.00 | $2,570.40 | $10,232.93 |
Blue Shield Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $3,090.30 | Professional | None | $891.25 | $1,288.25 | $3,090.30 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,412.54 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,466.84 Typical High $8,912.51 | Facility | None | $758.58 | $4,466.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $3,311.31 | Professional | None | $1,148.15 | $1,513.56 | $3,311.31 |
Contra Costa Health Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,513.56 | Professional | None | $891.25 | $1,258.93 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,691.53 | Professional | None | $1,071.52 | $1,380.38 | $2,691.53 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,912.51 | Professional | None | $8,317.64 | $8,317.64 | $8,912.51 |
Molina Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $4,365.16 Typical High $10,000.00 | Facility | None | $812.83 | $4,365.16 | $10,000.00 |
Providence Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $3,311.31 | Professional | None | $1,122.02 | $1,513.56 | $3,311.31 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
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 $912.01 Median $1,258.93 Typical High $3,388.44 | Professional | None | $912.01 | $1,258.93 | $3,388.44 |
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 $602.56 Median $630.96 Typical High $660.69 | Professional | 52 · Reduced service | $602.56 | $630.96 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $251.19 Typical High $269.15 | Professional | 53 · Discontinued | $239.88 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $933.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $891.25 | $933.25 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $186.21 Typical High $199.53 | Professional | 55 · Aftercare only | $181.97 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $125.89 Typical High $131.83 | Professional | 56 · Pre-op care only | $120.23 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $870.96 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $831.76 | $870.96 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,778.28 Typical High $4,168.69 | Professional | 50 · Both sides | $1,445.44 | $1,778.28 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $741.31 Typical High $1,737.80 | Professional | 62 · Two surgeons | $616.60 | $741.31 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $186.21 Typical High $446.68 | Professional | 80 · Assistant surgeon | $154.88 | $186.21 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $165.96 Typical High $389.05 | Professional | AS · PA/NP assist | $134.90 | $165.96 | $389.05 |
Where California sits
The same service costs 6.8 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· 23rd of 51
$1,738
AK $4,786TX $708
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.