How much rates vary
Facilitymedian $2,884 · 10th to 90th $977 to $9,772Professionalmedian $1,072 · 10th to 90th $871 to $7,943
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 $1,905.46 Median $6,165.95 Typical High $15,848.93 | Facility | None | $1,905.46 | $6,165.95 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $1,202.26 | Professional | None | $933.25 | $977.24 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,309.57 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,309.57 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,819.70 | Professional | None | $933.25 | $1,047.13 | $1,819.70 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,570.40 Typical High $7,244.36 | Facility | None | $100.00 | $2,570.40 | $7,244.36 |
Blue Shield Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,148.15 | Professional | None | $645.65 | $933.25 | $1,148.15 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $457.09 Median $1,348.96 Typical High $1,348.96 | Professional | None | $457.09 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,187.76 Typical High $4,466.84 | Facility | None | $575.44 | $2,187.76 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,737.80 | Professional | None | $933.25 | $1,096.48 | $1,737.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $309.03 Median $1,230.27 Typical High $1,348.96 | Professional | None | $309.03 | $1,230.27 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $2,290.87 | Professional | None | $1,000.00 | $1,122.02 | $2,290.87 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $8,912.51 Typical High $8,912.51 | Professional | None | $7,943.28 | $8,912.51 | $8,912.51 |
Molina Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $616.60 Median $2,187.76 Typical High $4,897.79 | Facility | None | $616.60 | $2,187.76 | $4,897.79 |
Providence Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,659.59 | Professional | None | $933.25 | $1,096.48 | $1,659.59 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,365.16 | $14,454.40 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,737.80 | Professional | None | $851.14 | $1,071.52 | $1,737.80 |
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 $467.74 Median $489.78 Typical High $549.54 | Professional | 52 · Reduced service | $467.74 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $223.87 | Professional | 53 · Discontinued | $186.21 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $831.76 | Professional | 54 · Surgery only | $691.83 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $165.96 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $97.72 Typical High $112.20 | Professional | 56 · Pre-op care only | $93.33 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $691.83 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $645.65 | $691.83 | $776.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $616.60 Typical High $1,258.93 | Professional | 62 · Two surgeons | $512.86 | $616.60 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $154.88 Typical High $316.23 | Professional | 80 · Assistant surgeon | $128.82 | $154.88 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $138.04 Typical High $275.42 | Professional | AS · PA/NP assist | $114.82 | $138.04 | $275.42 |
Where California sits
The same service costs 5.2 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
$1,072
AK $3,981TX $759
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.