How much rates vary
Facilitymedian $3,548 · 10th to 90th $646 to $23,442Professionalmedian $631 · 10th to 90th $513 to $4,786
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 $524.81 Median $562.34 Typical High $660.69 | Professional | None | $524.81 | $562.34 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $6,918.31 Typical High $15,135.61 | Facility | None | $4,265.80 | $6,918.31 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,071.52 | Professional | None | $602.56 | $602.56 | $1,071.52 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $2,398.83 Typical High $5,623.41 | Facility | None | $95.50 | $2,398.83 | $5,623.41 |
Blue Shield Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $758.58 | Professional | None | $426.58 | $602.56 | $758.58 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $851.14 | Professional | None | $676.08 | $851.14 | $851.14 |
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 $549.54 Median $602.56 Typical High $1,023.29 | Professional | None | $549.54 | $602.56 | $1,023.29 |
Contra Costa Health Setting Professional Modifier None Typical Low $467.74 Median $758.58 Typical High $831.76 | Professional | None | $467.74 | $758.58 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,445.44 | Professional | None | $630.96 | $707.95 | $1,445.44 |
Lucent Health Setting Professional Modifier None Typical Low $4,786.30 Median $5,888.44 Typical High $5,888.44 | Professional | None | $4,786.30 | $5,888.44 | $5,888.44 |
Molina Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
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 $758.58 Median $151,356.12 Typical High $251,188.64 | Facility | None | $758.58 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $977.24 | Professional | None | $549.54 | $588.84 | $977.24 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $501.19 Median $630.96 Typical High $1,047.13 | Professional | None | $501.19 | $630.96 | $1,047.13 |
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 $263.03 Median $281.84 Typical High $316.23 | Professional | 52 · Reduced service | $263.03 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $107.15 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $398.11 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $85.11 Typical High $95.50 | Professional | 55 · Aftercare only | $79.43 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $56.23 Typical High $64.57 | Professional | 56 · Pre-op care only | $52.48 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $371.54 | $389.05 | $446.68 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $416.87 Typical High $758.58 | Professional | 62 · Two surgeons | $331.13 | $416.87 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $104.71 Typical High $194.98 | Professional | 80 · Assistant surgeon | $85.11 | $104.71 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $91.20 Typical High $169.82 | Professional | AS · PA/NP assist | $74.13 | $91.20 | $169.82 |
Where California sits
The same service costs 5.4 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· 44th of 51
$646
AK $2,512TX $468
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.