How much rates vary
Facilitymedian $4,467 · 10th to 90th $661 to $28,840Professionalmedian $1,000 · 10th to 90th $708 to $5,754
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 $933.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $954.99 | Professional | None | $741.31 | $741.31 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $9,332.54 Typical High $18,620.87 | Facility | None | $5,011.87 | $9,332.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $3,235.94 | Professional | None | $977.24 | $1,096.48 | $3,235.94 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $2,137.96 Typical High $9,120.11 | Facility | None | $95.50 | $2,137.96 | $9,120.11 |
Blue Shield Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $2,187.76 | Professional | None | $660.69 | $954.99 | $2,187.76 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,698.24 | Professional | None | $794.33 | $977.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $10,000.00 | Facility | None | $660.69 | $1,412.54 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $2,238.72 | Professional | None | $758.58 | $891.25 | $2,238.72 |
Contra Costa Health Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,174.90 | Professional | None | $870.96 | $954.99 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,862.09 | Professional | None | $776.25 | $977.24 | $1,862.09 |
Lucent Health Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $6,918.31 | Professional | None | $5,754.40 | $5,754.40 | $6,918.31 |
Molina Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $812.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $2,238.72 | Professional | None | $758.58 | $870.96 | $2,238.72 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $2,344.23 | Professional | None | $645.65 | $851.14 | $2,344.23 |
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 $371.54 Median $371.54 Typical High $407.38 | Professional | 52 · Reduced service | $371.54 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | 53 · Discontinued | $147.91 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $83.18 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $575.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $537.03 Typical High $1,230.27 | Professional | 62 · Two surgeons | $416.87 | $537.03 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $134.90 Typical High $316.23 | Professional | 80 · Assistant surgeon | $107.15 | $134.90 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $117.49 Typical High $275.42 | Professional | AS · PA/NP assist | $93.33 | $117.49 | $275.42 |
Where California sits
The same service costs 6.2 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· 22nd of 51
$1,148
AK $3,311TX $537
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.