How much rates vary
Facilitymedian $4,677 · 10th to 90th $550 to $151,356Professionalmedian $347 · 10th to 90th $170 to $1,820
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 $1,621.81 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,621.81 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $1,621.81 Typical High $1,621.81 | Professional | None | $323.59 | $1,621.81 | $1,621.81 |
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 $741.31 Median $776.25 Typical High $1,000.00 | Professional | None | $741.31 | $776.25 | $1,000.00 |
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 $154.88 Median $223.87 Typical High $251.19 | Professional | None | $154.88 | $223.87 | $251.19 |
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 $223.87 Median $338.84 Typical High $524.81 | Professional | None | $223.87 | $338.84 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $524.81 | Professional | None | $213.80 | $234.42 | $524.81 |
Lucent Health Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
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 $223.87 Median $302.00 Typical High $478.63 | Professional | None | $223.87 | $302.00 | $478.63 |
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 $169.82 Median $223.87 Typical High $323.59 | Professional | None | $169.82 | $223.87 | $323.59 |
6 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 $239.88 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $239.88 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $47.86 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $31.62 | $162.18 | $162.18 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $125.89 Median $1,148.15 Typical High $1,479.11 | Professional | 62 · Two surgeons | $125.89 | $1,148.15 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $32.36 Median $295.12 Typical High $371.54 | Professional | 80 · Assistant surgeon | $32.36 | $295.12 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $28.18 Median $257.04 Typical High $323.59 | Professional | AS · PA/NP assist | $28.18 | $257.04 | $323.59 |
Where California sits
The same service costs 8.1 times more in New York than in Missouri. 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· 17th of 51
$380
NY $1,820MO $224
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.