How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,175 to $13,183Professionalmedian $1,230 · 10th to 90th $871 to $8,710
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 $912.01 Median $912.01 Typical High $1,548.82 | Professional | None | $912.01 | $912.01 | $1,548.82 |
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 $891.25 Median $1,230.27 Typical High $4,466.84 | Professional | None | $891.25 | $1,230.27 | $4,466.84 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $2,454.71 Typical High $7,413.10 | Facility | None | $91.20 | $2,454.71 | $7,413.10 |
Blue Shield Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $2,454.71 | Professional | None | $676.08 | $977.24 | $2,454.71 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,148.15 | $1,479.11 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,466.84 Typical High $7,413.10 | Facility | None | $758.58 | $4,466.84 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $3,162.28 | Professional | None | $933.25 | $1,148.15 | $3,162.28 |
Contra Costa Health Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,584.89 | Professional | None | $977.24 | $1,318.26 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,412.54 | $2,754.23 |
Lucent Health Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $9,332.54 | Professional | None | $8,709.64 | $8,709.64 | $9,332.54 |
Molina Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $4,265.80 Typical High $7,079.46 | Facility | None | $831.76 | $4,265.80 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $3,162.28 | Professional | None | $933.25 | $1,096.48 | $3,162.28 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
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 $851.14 Median $1,230.27 Typical High $3,548.13 | Professional | None | $851.14 | $1,230.27 | $3,548.13 |
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 $457.09 Median $457.09 Typical High $562.34 | Professional | 52 · Reduced service | $457.09 | $457.09 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $229.09 | Professional | 53 · Discontinued | $181.97 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $691.83 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $169.82 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $794.33 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $724.44 Typical High $1,698.24 | Professional | 62 · Two surgeons | $575.44 | $724.44 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $181.97 Typical High $436.52 | Professional | 80 · Assistant surgeon | $147.91 | $181.97 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $158.49 Typical High $380.19 | Professional | AS · PA/NP assist | $128.82 | $158.49 | $380.19 |
Where California sits
The same service costs 6.5 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· 26th of 51
$1,585
AK $4,898TX $759
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.