How much rates vary
Facilitymedian $5,495 · 10th to 90th $631 to $151,356Professionalmedian $1,096 · 10th to 90th $40 to $1,995
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 $1,995.26 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,995.26 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $8,128.31 Typical High $16,595.87 | Facility | None | $4,570.88 | $8,128.31 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $1,348.96 | Professional | None | $1,047.13 | $1,096.48 | $1,348.96 |
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 $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,445.44 Typical High $10,000.00 | Facility | None | $660.69 | $1,445.44 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $1,148.15 | Professional | None | $346.74 | $524.81 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $5,754.40 Typical High $8,709.64 | Professional | None | $630.96 | $5,754.40 | $8,709.64 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
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 $831.76 Median $151,356.12 Typical High $251,188.64 | Facility | None | $831.76 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $478.63 Typical High $1,071.52 | Professional | None | $79.43 | $478.63 | $1,071.52 |
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 |
7 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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $199.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $173.78 Typical High $218.78 | Professional | 80 · Assistant surgeon | $104.71 | $173.78 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $151.36 Typical High $190.55 | Professional | AS · PA/NP assist | $91.20 | $151.36 | $190.55 |
Where California sits
The same service costs 117.5 times more in Nebraska than in Hawaii. 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
$1,096
NE $3,467HI $29.51
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.