How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,175 to $14,125Professionalmedian $1,096 · 10th to 90th $891 to $2,951
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 $2,398.83 Median $8,912.51 Typical High $19,054.61 | Facility | None | $2,398.83 | $8,912.51 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,122.02 | Professional | None | $1,000.00 | $1,071.52 | $1,122.02 |
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 $1,071.52 Median $1,071.52 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,071.52 | $1,949.84 |
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 $794.33 Median $1,122.02 Typical High $1,412.54 | Professional | None | $794.33 | $1,122.02 | $1,412.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,258.93 | $1,445.44 |
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 $977.24 Median $1,096.48 Typical High $1,737.80 | Professional | None | $977.24 | $1,096.48 | $1,737.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,230.27 | Professional | None | $812.83 | $1,122.02 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $2,290.87 | Professional | None | $933.25 | $1,023.29 | $2,290.87 |
Lucent Health Setting Professional Modifier None Typical Low $12,022.64 Median $12,022.64 Typical High $12,022.64 | Professional | None | $12,022.64 | $12,022.64 | $12,022.64 |
Molina Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $4,265.80 Typical High $10,000.00 | Facility | None | $912.01 | $4,265.80 | $10,000.00 |
Providence Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,698.24 | Professional | None | $977.24 | $1,096.48 | $1,698.24 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
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 $851.14 Median $1,096.48 Typical High $1,778.28 | Professional | None | $851.14 | $1,096.48 | $1,778.28 |
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 $467.74 Median $501.19 Typical High $562.34 | Professional | 52 · Reduced service | $467.74 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $229.09 | Professional | 53 · Discontinued | $186.21 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $741.31 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $147.91 Typical High $169.82 | Professional | 55 · Aftercare only | $141.25 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $112.20 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $691.83 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $660.69 | $691.83 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $177.83 Typical High $316.23 | Professional | 80 · Assistant surgeon | $144.54 | $177.83 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $154.88 Typical High $281.84 | Professional | AS · PA/NP assist | $125.89 | $154.88 | $281.84 |
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· 41st of 51
$1,096
AK $4,365TX $708
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.