How much rates vary
Facilitymedian $5,495 · 10th to 90th $589 to $15,488Professionalmedian $2,239 · 10th to 90th $40 to $3,162
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 $3,162.28 Median $8,128.31 Typical High $19,054.61 | Facility | None | $3,162.28 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $9,120.11 Typical High $19,054.61 | Facility | None | $5,495.41 | $9,120.11 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $2,238.72 Typical High $2,818.38 | Professional | None | $2,187.76 | $2,238.72 | $2,818.38 |
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 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $630.96 Typical High $831.76 | Professional | None | $128.82 | $630.96 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $43,651.58 Median $43,651.58 Typical High $43,651.58 | Professional | None | $43,651.58 | $43,651.58 | $43,651.58 |
Molina Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
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 $3,162.28 Median $4,466.84 Typical High $4,466.84 | Facility | None | $3,162.28 | $4,466.84 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $89.13 | Professional | None | $60.26 | $79.43 | $89.13 |
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 $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,584.89 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $2,344.23 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $316.23 | $316.23 | $316.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $199.53 Typical High $436.52 | Professional | 80 · Assistant surgeon | $154.88 | $199.53 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $173.78 Typical High $380.19 | Professional | AS · PA/NP assist | $134.90 | $173.78 | $380.19 |
Where California sits
The same service costs 257.0 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· 45th of 51
$2,239
WI $7,586HI $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.