How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,175 to $16,982Professionalmedian $832 · 10th to 90th $617 to $2,455
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 $3,090.30 Median $9,120.11 Typical High $19,498.45 | Facility | None | $3,090.30 | $9,120.11 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $758.58 | Professional | None | $645.65 | $676.08 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $11,748.98 Typical High $20,417.38 | Facility | None | $5,888.44 | $11,748.98 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,412.54 | Professional | None | $724.44 | $851.14 | $1,412.54 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,548.13 Typical High $19,054.61 | Facility | None | $100.00 | $3,548.13 | $19,054.61 |
Blue Shield Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $954.99 | Professional | None | $549.54 | $776.25 | $954.99 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $891.25 | Professional | None | $645.65 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,466.84 Typical High $10,000.00 | Facility | None | $851.14 | $4,466.84 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,174.90 | Professional | None | $676.08 | $758.58 | $1,174.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $436.52 Median $812.83 Typical High $891.25 | Professional | None | $436.52 | $812.83 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,621.81 | Professional | None | $676.08 | $758.58 | $1,621.81 |
Lucent Health Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,709.64 | $8,709.64 | $8,709.64 |
Molina Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
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 $870.96 Median $4,466.84 Typical High $10,000.00 | Facility | None | $870.96 | $4,466.84 | $10,000.00 |
Providence Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,148.15 | Professional | None | $676.08 | $758.58 | $1,148.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $18,620.87 | Facility | None | $2,884.03 | $6,760.83 | $18,620.87 |
United Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,174.90 | Professional | None | $602.56 | $758.58 | $1,174.90 |
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 $323.59 Median $338.84 Typical High $380.19 | Professional | 52 · Reduced service | $323.59 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $138.04 Typical High $154.88 | Professional | 53 · Discontinued | $128.82 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $512.86 Typical High $575.44 | Professional | 54 · Surgery only | $489.78 | $512.86 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $102.33 Typical High $114.82 | Professional | 55 · Aftercare only | $97.72 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $478.63 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $457.09 | $478.63 | $537.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $446.68 Typical High $933.25 | Professional | 62 · Two surgeons | $354.81 | $446.68 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $112.20 Typical High $234.42 | Professional | 80 · Assistant surgeon | $91.20 | $112.20 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $97.72 Typical High $208.93 | Professional | AS · PA/NP assist | $79.43 | $97.72 | $208.93 |
Where California sits
The same service costs 25.1 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· 38th of 51
$832
AK $3,090TX $123
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.