How much rates vary
Facilitymedian $5,623 · 10th to 90th $537 to $50,119Professionalmedian $309 · 10th to 90th $229 to $3,162
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 $239.88 Median $269.15 Typical High $346.74 | Professional | None | $239.88 | $269.15 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,413.10 Median $12,882.50 Typical High $26,302.68 | Facility | None | $7,413.10 | $12,882.50 | $26,302.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $977.24 | Professional | None | $302.00 | $338.84 | $977.24 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,606.93 | Facility | None | $67.61 | $3,090.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $707.95 | Professional | None | $213.80 | $302.00 | $707.95 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $398.11 | Professional | None | $223.87 | $275.42 | $398.11 |
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 $245.47 Median $288.40 Typical High $707.95 | Professional | None | $245.47 | $288.40 | $707.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $316.23 | Professional | None | $208.93 | $263.03 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $660.69 | Professional | None | $223.87 | $288.40 | $660.69 |
Lucent Health Setting Professional Modifier None Typical Low $3,162.28 Median $4,265.80 Typical High $4,265.80 | Professional | None | $3,162.28 | $4,265.80 | $4,265.80 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Providence Setting Facility Modifier None Typical Low $512.86 Median $151,356.12 Typical High $251,188.64 | Facility | None | $512.86 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $707.95 | Professional | None | $245.47 | $275.42 | $707.95 |
Sutter Health Plus Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
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 $208.93 Median $281.84 Typical High $758.58 | Professional | None | $208.93 | $281.84 | $758.58 |
8 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 $120.23 Median $120.23 Typical High $125.89 | Professional | 52 · Reduced service | $120.23 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $50.12 | Professional | 53 · Discontinued | $47.86 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $190.55 | Professional | 54 · Surgery only | $177.83 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $38.02 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $25.12 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $25.12 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $138.04 Median $173.78 Typical High $407.38 | Professional | 62 · Two surgeons | $138.04 | $173.78 | $407.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $34.67 Median $44.67 Typical High $102.33 | Professional | 80 · Assistant surgeon | $34.67 | $44.67 | $102.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $30.20 Median $38.90 Typical High $89.13 | Professional | AS · PA/NP assist | $30.20 | $38.90 | $89.13 |
Where California sits
The same service costs 32.0 times more in Maine than in Montana. 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
ME $26,674MT $834
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.