How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,096 to $14,125Professionalmedian $955 · 10th to 90th $776 to $3,236
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 $2,570.40 Median $8,912.51 Typical High $19,054.61 | Facility | None | $2,570.40 | $8,912.51 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $1,047.13 | Professional | None | $851.14 | $912.01 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $10,964.78 Typical High $20,417.38 | Facility | None | $4,786.30 | $10,964.78 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,698.24 | Professional | None | $933.25 | $933.25 | $1,698.24 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,290.87 Typical High $10,471.29 | Facility | None | $100.00 | $2,290.87 | $10,471.29 |
Blue Shield Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,258.93 | Professional | None | $707.95 | $1,000.00 | $1,258.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,258.93 | Professional | None | $891.25 | $1,122.02 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,344.23 Typical High $4,897.79 | Facility | None | $851.14 | $2,344.23 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,548.82 | Professional | None | $851.14 | $954.99 | $1,548.82 |
Contra Costa Health Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,096.48 | Professional | None | $741.31 | $1,000.00 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,949.84 | Professional | None | $831.76 | $912.01 | $1,949.84 |
Lucent Health Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Professional | None | $9,332.54 | $9,332.54 | $9,332.54 |
Molina Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $2,398.83 Typical High $7,585.78 | Facility | None | $912.01 | $2,398.83 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,513.56 | Professional | None | $851.14 | $933.25 | $1,513.56 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,495.41 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,495.41 | $17,378.01 |
United Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,584.89 | Professional | None | $758.58 | $954.99 | $1,584.89 |
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 $426.58 Median $457.09 Typical High $524.81 | Professional | 52 · Reduced service | $426.58 | $457.09 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $181.97 Typical High $208.93 | Professional | 53 · Discontinued | $169.82 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $676.08 Typical High $794.33 | Professional | 54 · Surgery only | $645.65 | $676.08 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $138.04 Typical High $158.49 | Professional | 55 · Aftercare only | $128.82 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $91.20 Typical High $104.71 | Professional | 56 · Pre-op care only | $85.11 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $630.96 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $602.56 | $630.96 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $154.88 Typical High $288.40 | Professional | 80 · Assistant surgeon | $125.89 | $154.88 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $134.90 Typical High $251.19 | Professional | AS · PA/NP assist | $112.20 | $134.90 | $251.19 |
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· 40th of 51
$977
AK $3,802TX $617
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.