How much rates vary
Facilitymedian $4,677 · 10th to 90th $676 to $33,884Professionalmedian $851 · 10th to 90th $631 to $5,495
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 $2,818.38 Median $9,120.11 Typical High $21,379.62 | Facility | None | $2,818.38 | $9,120.11 | $21,379.62 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $776.25 | Professional | None | $660.69 | $691.83 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,128.31 Median $14,454.40 Typical High $28,840.32 | Facility | None | $8,128.31 | $14,454.40 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,548.82 | Professional | None | $758.58 | $870.96 | $1,548.82 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $3,090.30 Typical High $6,760.83 | Facility | None | $91.20 | $3,090.30 | $6,760.83 |
Blue Shield Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $954.99 | Professional | None | $549.54 | $776.25 | $954.99 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $933.25 | Professional | None | $724.44 | $891.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,778.28 Typical High $18,197.01 | Facility | None | $660.69 | $1,778.28 | $18,197.01 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,202.26 | Professional | None | $691.83 | $776.25 | $1,202.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $891.25 | Professional | None | $524.81 | $794.33 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,621.81 | Professional | None | $676.08 | $758.58 | $1,621.81 |
Lucent Health Setting Professional Modifier None Typical Low $5,495.41 Median $6,456.54 Typical High $6,456.54 | Professional | None | $5,495.41 | $6,456.54 | $6,456.54 |
Molina Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $691.83 Median $776.25 Typical High $1,174.90 | Professional | None | $691.83 | $776.25 | $1,174.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
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 $616.60 Median $776.25 Typical High $1,202.26 | Professional | None | $616.60 | $776.25 | $1,202.26 |
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 $331.13 Median $346.74 Typical High $389.05 | Professional | 52 · Reduced service | $331.13 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $138.04 Typical High $154.88 | Professional | 53 · Discontinued | $131.83 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $524.81 Typical High $575.44 | Professional | 54 · Surgery only | $489.78 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $104.71 Typical High $117.49 | Professional | 55 · Aftercare only | $97.72 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $69.18 Typical High $77.62 | Professional | 56 · Pre-op care only | $66.07 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $489.78 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $457.09 | $489.78 | $537.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $457.09 Typical High $933.25 | Professional | 62 · Two surgeons | $363.08 | $457.09 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $120.23 Typical High $245.47 | Professional | 80 · Assistant surgeon | $91.20 | $120.23 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $102.33 Typical High $208.93 | Professional | AS · PA/NP assist | $81.28 | $102.33 | $208.93 |
Where California sits
The same service costs 5.9 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· 38th of 51
$851
AK $3,162TX $537
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.