How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,023 to $14,454Professionalmedian $661 · 10th to 90th $525 to $4,571
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 $2,398.83 Median $7,413.10 Typical High $17,378.01 | Facility | None | $2,398.83 | $7,413.10 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $933.25 | Professional | None | $549.54 | $645.65 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $11,748.98 Typical High $21,379.62 | Facility | None | $6,025.60 | $11,748.98 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,174.90 | Professional | None | $630.96 | $724.44 | $1,174.90 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,467.37 Typical High $12,302.69 | Facility | None | $100.00 | $3,467.37 | $12,302.69 |
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 $602.56 Median $741.31 Typical High $758.58 | Professional | None | $602.56 | $741.31 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,466.84 Typical High $8,317.64 | Facility | None | $758.58 | $4,466.84 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $977.24 | Professional | None | $562.34 | $630.96 | $977.24 |
Contra Costa Health Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $741.31 | Professional | None | $426.58 | $676.08 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $1,348.96 | Professional | None | $562.34 | $630.96 | $1,348.96 |
Lucent Health Setting Professional Modifier None Typical Low $4,570.88 Median $5,248.07 Typical High $5,248.07 | Professional | None | $4,570.88 | $5,248.07 | $5,248.07 |
Molina Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
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 $4,466.84 Typical High $8,317.64 | Facility | None | $758.58 | $4,466.84 | $8,317.64 |
Providence Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $954.99 | Professional | None | $562.34 | $630.96 | $954.99 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,754.40 | $17,378.01 |
United Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $1,000.00 | Professional | None | $501.19 | $630.96 | $1,000.00 |
10 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 $275.42 Median $288.40 Typical High $323.59 | Professional | 52 · Reduced service | $275.42 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $117.49 Typical High $131.83 | Professional | 53 · Discontinued | $109.65 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $436.52 Typical High $489.78 | Professional | 54 · Surgery only | $416.87 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $87.10 Typical High $97.72 | Professional | 55 · Aftercare only | $83.18 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $58.88 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $407.38 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $389.05 | $407.38 | $457.09 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | GC · Resident with teaching physician | $1,122.02 | $1,122.02 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $380.19 Typical High $724.44 | Professional | 62 · Two surgeons | $295.12 | $380.19 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $95.50 Typical High $194.98 | Professional | 80 · Assistant surgeon | $75.86 | $95.50 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $83.18 Typical High $162.18 | Professional | AS · PA/NP assist | $66.07 | $83.18 | $162.18 |
Where California sits
The same service costs 5.4 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $11,084MT $2,070
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.