How much rates vary
Facilitymedian $4,266 · 10th to 90th $891 to $12,023Professionalmedian $813 · 10th to 90th $603 to $2,138
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 $7,244.36 Typical High $17,782.79 | Facility | None | $933.25 | $7,244.36 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $933.25 | Professional | None | $616.60 | $724.44 | $933.25 |
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 $676.08 Median $812.83 Typical High $1,096.48 | Professional | None | $676.08 | $812.83 | $1,096.48 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,290.87 Typical High $9,549.93 | Facility | None | $100.00 | $2,290.87 | $9,549.93 |
Blue Shield Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,047.13 | Professional | None | $549.54 | $794.33 | $1,047.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,174.90 | Professional | None | $691.83 | $776.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,466.84 Typical High $7,413.10 | Facility | None | $758.58 | $4,466.84 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,148.15 | Professional | None | $691.83 | $831.76 | $1,148.15 |
Contra Costa Health Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,148.15 | Professional | None | $549.54 | $741.31 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,412.54 | Professional | None | $602.56 | $891.25 | $1,412.54 |
Lucent Health Setting Professional Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $7,413.10 | Professional | None | $6,165.95 | $7,413.10 | $7,413.10 |
Molina Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,230.27 | Professional | None | $741.31 | $741.31 | $1,230.27 |
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 $758.58 Median $4,073.80 Typical High $7,762.47 | Facility | None | $758.58 | $4,073.80 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,071.52 | Professional | None | $691.83 | $831.76 | $1,071.52 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,754.23 | Professional | None | $2,137.96 | $2,137.96 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $11,220.18 | Facility | None | $1,258.93 | $3,090.30 | $11,220.18 |
United Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,230.27 | Professional | None | $537.03 | $758.58 | $1,230.27 |
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 $316.23 Median $363.08 Typical High $457.09 | Facility | 52 · Reduced service | $316.23 | $363.08 | $457.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $125.89 Median $144.54 Typical High $186.21 | Facility | 53 · Discontinued | $125.89 | $144.54 | $186.21 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $478.63 Median $549.54 Typical High $691.83 | Facility | 54 · Surgery only | $478.63 | $549.54 | $691.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $95.50 Median $109.65 Typical High $138.04 | Facility | 55 · Aftercare only | $95.50 | $109.65 | $138.04 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $63.10 Median $72.44 Typical High $93.33 | Facility | 56 · Pre-op care only | $63.10 | $72.44 | $93.33 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $512.86 Typical High $645.65 | Facility | 78 · Unplanned return to OR | $446.68 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $363.08 Typical High $457.09 | Professional | 52 · Reduced service | $309.03 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $144.54 Typical High $186.21 | Professional | 53 · Discontinued | $125.89 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $549.54 Typical High $691.83 | Professional | 54 · Surgery only | $467.74 | $549.54 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $109.65 Typical High $138.04 | Professional | 55 · Aftercare only | $93.33 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $93.33 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $512.86 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $436.52 | $512.86 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $125.89 Typical High $213.80 | Professional | 80 · Assistant surgeon | $100.00 | $125.89 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $109.65 Typical High $186.21 | Professional | AS · PA/NP assist | $89.13 | $109.65 | $186.21 |
Where California sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 38th of 51
$813
AK $2,754NJ $631
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.