How much rates vary
Facilitymedian $4,467 · 10th to 90th $479 to $14,791Professionalmedian $240 · 10th to 90th $200 to $776
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 $208.93 Median $218.78 Typical High $239.88 | Professional | None | $208.93 | $218.78 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $9,332.54 Typical High $19,498.45 | Facility | None | $5,495.41 | $9,332.54 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $446.68 | Professional | None | $239.88 | $239.88 | $446.68 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,606.93 | Facility | None | $67.61 | $3,090.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $316.23 | Professional | None | $181.97 | $257.04 | $316.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $281.84 | Professional | None | $208.93 | $251.19 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,174.90 Typical High $5,623.41 | Facility | None | $660.69 | $1,174.90 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $371.54 | Professional | None | $223.87 | $239.88 | $371.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $245.47 | Professional | None | $199.53 | $223.87 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $478.63 | Professional | None | $194.98 | $218.78 | $478.63 |
Lucent Health Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $263.03 Median $870.96 Typical High $5,623.41 | Facility | None | $263.03 | $870.96 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $363.08 | Professional | None | $223.87 | $239.88 | $363.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $371.54 | Professional | None | $190.55 | $239.88 | $371.54 |
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 $102.33 Median $109.65 Typical High $120.23 | Professional | 52 · Reduced service | $102.33 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $43.65 Typical High $47.86 | Professional | 53 · Discontinued | $41.69 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $162.18 Typical High $177.83 | Professional | 54 · Surgery only | $154.88 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $30.90 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.88 Typical High $23.99 | Professional | 56 · Pre-op care only | $20.89 | $21.88 | $23.99 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $125.89 Median $151.36 Typical High $288.40 | Professional | 62 · Two surgeons | $125.89 | $151.36 | $288.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $38.90 Typical High $72.44 | Professional | 80 · Assistant surgeon | $31.62 | $38.90 | $72.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $28.18 Median $33.88 Typical High $63.10 | Professional | AS · PA/NP assist | $28.18 | $33.88 | $63.10 |
Where California sits
The same service costs 5.0 times more in Alaska than in Utah. 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
$245
AK $977UT $195
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.