How much rates vary
Facilitymedian $5,495 · 10th to 90th $631 to $50,119Professionalmedian $977 · 10th to 90th $794 to $7,079
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 $1,023.29 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,023.29 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $1,023.29 | Professional | None | $851.14 | $891.25 | $1,023.29 |
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 $912.01 Median $954.99 Typical High $1,621.81 | Professional | None | $912.01 | $954.99 | $1,621.81 |
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 $616.60 Median $891.25 Typical High $1,122.02 | Professional | None | $616.60 | $891.25 | $1,122.02 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,258.93 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $10,000.00 | Facility | None | $660.69 | $1,412.54 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,548.82 | Professional | None | $851.14 | $1,000.00 | $1,548.82 |
Contra Costa Health Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,258.93 | Professional | None | $724.44 | $1,148.15 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $2,137.96 | Professional | None | $933.25 | $1,047.13 | $2,137.96 |
Lucent Health Setting Professional Modifier None Typical Low $7,079.46 Median $8,709.64 Typical High $8,709.64 | Professional | None | $7,079.46 | $8,709.64 | $8,709.64 |
Molina Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $851.14 Median $151,356.12 Typical High $251,188.64 | Facility | None | $851.14 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,513.56 | Professional | None | $851.14 | $1,000.00 | $1,513.56 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
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 $794.33 Median $954.99 Typical High $1,621.81 | Professional | None | $794.33 | $954.99 | $1,621.81 |
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 $426.58 Median $446.68 Typical High $512.86 | Professional | 52 · Reduced service | $426.58 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $181.97 Typical High $204.17 | Professional | 53 · Discontinued | $169.82 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $676.08 Typical High $776.25 | Professional | 54 · Surgery only | $630.96 | $676.08 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $134.90 Typical High $154.88 | Professional | 55 · Aftercare only | $125.89 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $102.33 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $630.96 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $588.84 | $630.96 | $724.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $630.96 Typical High $1,174.90 | Professional | 62 · Two surgeons | $512.86 | $630.96 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $162.18 Typical High $309.03 | Professional | 80 · Assistant surgeon | $131.83 | $162.18 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $141.25 Typical High $263.03 | Professional | AS · PA/NP assist | $114.82 | $141.25 | $263.03 |
Where California sits
The same service costs 4.9 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· 43rd of 51
$977
AK $3,548TX $724
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.