How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,023 to $13,804Professionalmedian $794 · 10th to 90th $631 to $2,399
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 $676.08 Median $724.44 Typical High $851.14 | Professional | None | $676.08 | $724.44 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,232.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $1,380.38 | Professional | None | $691.83 | $741.31 | $1,380.38 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,238.72 Typical High $10,715.19 | Facility | None | $100.00 | $2,238.72 | $10,715.19 |
Blue Shield Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $1,047.13 | Professional | None | $575.44 | $831.76 | $1,047.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,047.13 | Professional | None | $776.25 | $954.99 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,466.84 Typical High $7,413.10 | Facility | None | $851.14 | $4,466.84 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,174.90 | Professional | None | $707.95 | $812.83 | $1,174.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $933.25 | Professional | None | $602.56 | $851.14 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,584.89 | Professional | None | $676.08 | $776.25 | $1,584.89 |
Lucent Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
Molina Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
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 $794.33 Median $4,265.80 Typical High $8,317.64 | Facility | None | $794.33 | $4,265.80 | $8,317.64 |
Providence Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,148.15 | Professional | None | $707.95 | $794.33 | $1,148.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $562.34 Median $741.31 Typical High $1,202.26 | Professional | None | $562.34 | $741.31 | $1,202.26 |
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 $338.84 Median $363.08 Typical High $426.58 | Professional | 52 · Reduced service | $338.84 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $169.82 | Professional | 53 · Discontinued | $134.90 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $549.54 Typical High $645.65 | Professional | 54 · Surgery only | $512.86 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $128.82 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $85.11 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $512.86 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $478.63 | $512.86 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $117.49 Typical High $218.78 | Professional | 80 · Assistant surgeon | $93.33 | $117.49 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $102.33 Typical High $190.55 | Professional | AS · PA/NP assist | $81.28 | $102.33 | $190.55 |
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· 35th of 51
$794
AK $3,020TX $490
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.