How much rates vary
Facilitymedian $1,778 · 10th to 90th $575 to $9,772Professionalmedian $575 · 10th to 90th $457 to $4,074
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 $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $588.84 | Professional | None | $478.63 | $512.86 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $10,000.00 Typical High $18,620.87 | Facility | None | $4,570.88 | $10,000.00 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,000.00 | Professional | None | $549.54 | $549.54 | $1,000.00 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,041.74 Typical High $5,623.41 | Facility | None | $100.00 | $2,041.74 | $5,623.41 |
Blue Shield Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $707.95 | Professional | None | $407.38 | $575.44 | $707.95 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $912.01 | Professional | None | $660.69 | $691.83 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,047.13 Typical High $1,778.28 | Facility | None | $436.52 | $1,047.13 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $870.96 | Professional | None | $512.86 | $562.34 | $870.96 |
Contra Costa Health Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $691.83 | Professional | None | $524.81 | $616.60 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $1,202.26 | Professional | None | $524.81 | $588.84 | $1,202.26 |
Lucent Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,073.80 | $4,786.30 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
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 $512.86 Median $1,096.48 Typical High $2,754.23 | Facility | None | $512.86 | $1,096.48 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $851.14 | Professional | None | $512.86 | $562.34 | $851.14 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $870.96 | Professional | None | $436.52 | $549.54 | $870.96 |
9 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 $239.88 Median $251.19 Typical High $288.40 | Professional | 52 · Reduced service | $239.88 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $117.49 | Professional | 53 · Discontinued | $95.50 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $436.52 | Professional | 54 · Surgery only | $363.08 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $87.10 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $58.88 | Professional | 56 · Pre-op care only | $47.86 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $354.81 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $338.84 | $354.81 | $407.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $288.40 Median $354.81 Typical High $691.83 | Professional | 62 · Two surgeons | $288.40 | $354.81 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $89.13 Typical High $177.83 | Professional | 80 · Assistant surgeon | $72.44 | $89.13 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $79.43 Typical High $154.88 | Professional | AS · PA/NP assist | $63.10 | $79.43 | $154.88 |
Where California sits
The same service costs 5.5 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· 43rd of 51
$575
AK $2,188TX $398
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.