How much rates vary
Facilitymedian $4,571 · 10th to 90th $813 to $12,023Professionalmedian $525 · 10th to 90th $417 to $1,622
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 $2,238.72 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,238.72 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $588.84 | Professional | None | $467.74 | $501.19 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,511.38 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $891.25 | Professional | None | $467.74 | $524.81 | $891.25 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,238.72 Typical High $8,912.51 | Facility | None | $100.00 | $2,238.72 | $8,912.51 |
Blue Shield Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $691.83 | Professional | None | $371.54 | $537.03 | $691.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $776.25 | Professional | None | $549.54 | $588.84 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,466.84 Typical High $8,912.51 | Facility | None | $645.65 | $4,466.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $794.33 | Professional | None | $478.63 | $524.81 | $794.33 |
Contra Costa Health Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $588.84 | Professional | None | $436.52 | $524.81 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $1,023.29 | Professional | None | $426.58 | $478.63 | $1,023.29 |
Lucent Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Molina Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
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 $616.60 Median $4,168.69 Typical High $9,120.11 | Facility | None | $616.60 | $4,168.69 | $9,120.11 |
Providence Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $776.25 | Professional | None | $478.63 | $524.81 | $776.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $389.05 Median $501.19 Typical High $812.83 | Professional | None | $389.05 | $501.19 | $812.83 |
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 $229.09 Median $251.19 Typical High $295.12 | Professional | 52 · Reduced service | $229.09 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $100.00 Typical High $117.49 | Professional | 53 · Discontinued | $91.20 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $446.68 | Professional | 54 · Surgery only | $346.74 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $75.86 Typical High $89.13 | Professional | 55 · Aftercare only | $69.18 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $50.12 Typical High $58.88 | Professional | 56 · Pre-op care only | $45.71 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $323.59 | $354.81 | $416.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $75.86 Typical High $147.91 | Professional | 80 · Assistant surgeon | $60.26 | $75.86 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $66.07 Typical High $128.82 | Professional | AS · PA/NP assist | $52.48 | $66.07 | $128.82 |
Where California sits
The same service costs 6.3 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· 37th of 51
$537
AK $2,042TX $324
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.