How much rates vary
Facilitymedian $6,607 · 10th to 90th $525 to $21,380Professionalmedian $4,677 · 10th to 90th $3,236 to $38,905
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 $3,162.28 Median $8,128.31 Typical High $19,054.61 | Facility | None | $3,162.28 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $3,090.30 Median $3,235.94 Typical High $5,370.32 | Professional | None | $3,090.30 | $3,235.94 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,762.47 Median $16,982.44 Typical High $29,512.09 | Facility | None | $7,762.47 | $16,982.44 | $29,512.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,981.07 Median $4,466.84 Typical High $17,782.79 | Professional | None | $3,981.07 | $4,466.84 | $17,782.79 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $9,549.93 Typical High $19,498.45 | Facility | None | $67.61 | $9,549.93 | $19,498.45 |
Blue Shield Setting Professional Modifier None Typical Low $2,818.38 Median $3,981.07 Typical High $10,000.00 | Professional | None | $2,818.38 | $3,981.07 | $10,000.00 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3,548.13 Median $5,128.61 Typical High $5,370.32 | Professional | None | $3,548.13 | $5,128.61 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $10,471.29 | Professional | None | $7,244.36 | $7,244.36 | $10,471.29 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,818.38 Median $4,677.35 Typical High $5,623.41 | Professional | None | $2,818.38 | $4,677.35 | $5,623.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,265.80 Median $5,370.32 Typical High $25,703.96 | Professional | None | $4,265.80 | $5,370.32 | $25,703.96 |
Lucent Health Setting Professional Modifier None Typical Low $38,904.51 Median $162,181.01 Typical High $162,181.01 | Professional | None | $38,904.51 | $162,181.01 | $162,181.01 |
Molina Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Professional | None | $7,079.46 | $7,079.46 | $7,079.46 |
Providence Setting Facility Modifier None Typical Low $3,235.94 Median $4,570.88 Typical High $6,606.93 | Facility | None | $3,235.94 | $4,570.88 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $4,265.80 Median $7,943.28 Typical High $12,882.50 | Professional | None | $4,265.80 | $7,943.28 | $12,882.50 |
Sutter Health Plus Setting Professional Modifier None Typical Low $15,488.17 Median $15,488.17 Typical High $15,488.17 | Professional | None | $15,488.17 | $15,488.17 | $15,488.17 |
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 $3,388.44 Median $4,897.79 Typical High $13,803.84 | Professional | None | $3,388.44 | $4,897.79 | $13,803.84 |
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 $1,513.56 Median $1,513.56 Typical High $2,398.83 | Professional | 52 · Reduced service | $1,513.56 | $1,513.56 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $616.60 Typical High $954.99 | Professional | 53 · Discontinued | $616.60 | $616.60 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,290.87 Typical High $3,630.78 | Professional | 54 · Surgery only | $2,290.87 | $2,290.87 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $457.09 Typical High $724.44 | Professional | 55 · Aftercare only | $457.09 | $457.09 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $309.03 Typical High $478.63 | Professional | 56 · Pre-op care only | $309.03 | $309.03 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,137.96 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,137.96 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,344.23 Median $3,019.95 Typical High $7,244.36 | Professional | 62 · Two surgeons | $2,344.23 | $3,019.95 | $7,244.36 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $588.84 Median $758.58 Typical High $1,862.09 | Professional | 80 · Assistant surgeon | $588.84 | $758.58 | $1,862.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $524.81 Median $660.69 Typical High $1,621.81 | Professional | AS · PA/NP assist | $524.81 | $660.69 | $1,621.81 |
Where California sits
The same service costs 8.4 times more in Wisconsin 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.
Physician feeFacility fee
WI $28,671TX $3,407
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.