How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,202 to $14,125Professionalmedian $1,514 · 10th to 90th $1,047 to $6,457
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 $1,548.82 Median $8,128.31 Typical High $18,620.87 | Facility | None | $1,548.82 | $8,128.31 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,096.48 | $1,258.93 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $11,481.54 Typical High $20,417.38 | Facility | None | $5,888.44 | $11,481.54 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $4,265.80 | Professional | None | $1,202.26 | $1,548.82 | $4,265.80 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,290.87 Typical High $10,964.78 | Facility | None | $100.00 | $2,290.87 | $10,964.78 |
Blue Shield Setting Professional Modifier None Typical Low $912.01 Median $1,380.38 Typical High $3,388.44 | Professional | None | $912.01 | $1,380.38 | $3,388.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,380.38 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,466.84 Typical High $8,912.51 | Facility | None | $851.14 | $4,466.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $2,754.23 | Professional | None | $1,071.52 | $1,348.96 | $2,754.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $831.76 Median $1,348.96 Typical High $2,238.72 | Professional | None | $831.76 | $1,348.96 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $3,388.44 | Professional | None | $1,122.02 | $1,778.28 | $3,388.44 |
Lucent Health Setting Professional Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $14,125.38 | Professional | None | $10,964.78 | $10,964.78 | $14,125.38 |
Molina Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,288.25 | $2,137.96 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $4,073.80 Typical High $9,772.37 | Facility | None | $912.01 | $4,073.80 | $9,772.37 |
Providence Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,884.03 | Professional | None | $1,047.13 | $1,348.96 | $2,884.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $4,897.79 | Professional | None | $3,890.45 | $3,890.45 | $4,897.79 |
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 $977.24 Median $1,479.11 Typical High $3,715.35 | Professional | None | $977.24 | $1,479.11 | $3,715.35 |
14 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 Facility Modifier 52 · Reduced service Typical Low $549.54 Median $616.60 Typical High $776.25 | Facility | 52 · Reduced service | $549.54 | $616.60 | $776.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $218.78 Median $251.19 Typical High $309.03 | Facility | 53 · Discontinued | $218.78 | $251.19 | $309.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $812.83 Median $933.25 Typical High $1,148.15 | Facility | 54 · Surgery only | $812.83 | $933.25 | $1,148.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $162.18 Median $186.21 Typical High $229.09 | Facility | 55 · Aftercare only | $162.18 | $186.21 | $229.09 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $109.65 Median $125.89 Typical High $154.88 | Facility | 56 · Pre-op care only | $109.65 | $125.89 | $154.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $870.96 Typical High $1,071.52 | Facility | 78 · Unplanned return to OR | $758.58 | $870.96 | $1,071.52 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $616.60 Typical High $776.25 | Professional | 52 · Reduced service | $549.54 | $616.60 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $251.19 Typical High $309.03 | Professional | 53 · Discontinued | $218.78 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $933.25 Typical High $1,148.15 | Professional | 54 · Surgery only | $812.83 | $933.25 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $186.21 Typical High $229.09 | Professional | 55 · Aftercare only | $162.18 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $125.89 Typical High $154.88 | Professional | 56 · Pre-op care only | $109.65 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $870.96 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $758.58 | $870.96 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $204.17 Typical High $537.03 | Professional | 80 · Assistant surgeon | $158.49 | $204.17 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $177.83 Typical High $478.63 | Professional | AS · PA/NP assist | $138.04 | $177.83 | $478.63 |
Where California sits
The same service costs 5.2 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· 36th of 51
$1,585
AK $6,026TX $1,148
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.