How much rates vary
Facilitymedian $4,571 · 10th to 90th $550 to $151,356Professionalmedian $661 · 10th to 90th $302 to $5,248
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 $1,258.93 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,258.93 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,258.93 | $1,258.93 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,511.38 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,258.93 | Professional | None | $645.65 | $660.69 | $1,258.93 |
Blue Shield Setting Facility Modifier None Typical Low $48.98 Median $79.43 Typical High $100.00 | Facility | None | $48.98 | $79.43 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $676.08 | Professional | None | $239.88 | $338.84 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $10,000.00 | Facility | None | $660.69 | $1,258.93 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $1,348.96 | Professional | None | $354.81 | $537.03 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $2,511.89 | Professional | None | $363.08 | $398.11 | $2,511.89 |
Lucent Health Setting Professional Modifier None Typical Low $5,248.07 Median $7,244.36 Typical High $7,244.36 | Professional | None | $5,248.07 | $7,244.36 | $7,244.36 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $691.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $1,659.59 | Professional | None | $331.13 | $501.19 | $1,659.59 |
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 $263.03 Median $363.08 Typical High $1,148.15 | Professional | None | $263.03 | $363.08 | $1,148.15 |
6 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 54 · Surgery only Typical Low $371.54 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $371.54 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $75.86 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $50.12 | $125.89 | $125.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $117.49 Median $154.88 Typical High $912.01 | Professional | 62 · Two surgeons | $117.49 | $154.88 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.20 Median $38.90 Typical High $234.42 | Professional | 80 · Assistant surgeon | $30.20 | $38.90 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $26.30 Median $33.88 Typical High $204.17 | Professional | AS · PA/NP assist | $26.30 | $33.88 | $204.17 |
Where California sits
The same service costs 9.8 times more in Indiana than in Hawaii. 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· 8th of 51
$741
IN $2,344HI $240
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.