How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $151,356Professionalmedian $1,175 · 10th to 90th $40 to $1,660
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 $1,659.59 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,659.59 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $1,122.02 Median $1,174.90 Typical High $1,445.44 | Professional | None | $1,122.02 | $1,174.90 | $1,445.44 |
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 $10,000.00 Typical High $15,488.17 | Professional | None | $630.96 | $10,000.00 | $15,488.17 |
Lucent Health Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
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 $831.76 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $165.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $181.97 Typical High $218.78 | Professional | 80 · Assistant surgeon | $131.83 | $181.97 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $158.49 Typical High $190.55 | Professional | AS · PA/NP assist | $117.49 | $158.49 | $190.55 |
Where California sits
The same service costs 204.2 times more in Wisconsin 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· 39th of 51
$1,175
WI $6,026HI $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.