How much rates vary
Facilitymedian $4,677 · 10th to 90th $575 to $151,356Professionalmedian $832 · 10th to 90th $363 to $14,125
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 $2,290.87 Median $8,128.31 Typical High $19,054.61 | Facility | None | $2,290.87 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $2,290.87 Typical High $2,290.87 | Professional | None | $630.96 | $2,290.87 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,128.31 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $1,230.27 | Professional | None | $831.76 | $870.96 | $1,230.27 |
Blue Shield Setting Facility Modifier None Typical Low $48.98 Median $79.43 Typical High $100.00 | Facility | None | $48.98 | $79.43 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $537.03 | Professional | None | $331.13 | $467.74 | $537.03 |
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 $457.09 Median $660.69 Typical High $977.24 | Professional | None | $457.09 | $660.69 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $1,148.15 | Professional | None | $467.74 | $512.86 | $1,148.15 |
Lucent Health Setting Professional Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $16,595.87 | Professional | None | $14,125.38 | $14,125.38 | $16,595.87 |
Molina Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $151,356.12 Typical High $251,188.64 | Facility | None | $707.95 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $891.25 | Professional | None | $457.09 | $575.44 | $891.25 |
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 $363.08 Median $467.74 Typical High $707.95 | Professional | None | $363.08 | $467.74 | $707.95 |
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 54 · Surgery only Typical Low $467.74 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $467.74 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $93.33 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $63.10 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $436.52 | $1,621.81 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $223.87 Median $2,398.83 Typical High $3,019.95 | Professional | 62 · Two surgeons | $223.87 | $2,398.83 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $602.56 Typical High $776.25 | Professional | 80 · Assistant surgeon | $57.54 | $602.56 | $776.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $524.81 Typical High $676.08 | Professional | AS · PA/NP assist | $50.12 | $524.81 | $676.08 |
Where California sits
The same service costs 11.7 times more in New York than in North Carolina. 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· 11th of 51
$851
NY $3,802NC $324
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.