How much rates vary
Facilitymedian $3,311 · 10th to 90th $891 to $12,589Professionalmedian $398 · 10th to 90th $331 to $3,467
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 $2,238.72 Median $7,943.28 Typical High $18,197.01 | Facility | None | $2,238.72 | $7,943.28 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $616.60 | Professional | None | $338.84 | $398.11 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,232.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $691.83 | Professional | None | $380.19 | $389.05 | $691.83 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $9,332.54 | Facility | None | $100.00 | $2,137.96 | $9,332.54 |
Blue Shield Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $478.63 | Professional | None | $269.15 | $380.19 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,691.53 Typical High $5,248.07 | Facility | None | $758.58 | $2,691.53 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $630.96 | Professional | None | $346.74 | $389.05 | $630.96 |
Contra Costa Health Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $489.78 | Professional | None | $316.23 | $446.68 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $912.01 | Professional | None | $371.54 | $416.87 | $912.01 |
Lucent Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,467.37 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
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 $660.69 Median $2,754.23 Typical High $6,606.93 | Facility | None | $660.69 | $2,754.23 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $616.60 | Professional | None | $346.74 | $371.54 | $616.60 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $323.59 Median $398.11 Typical High $630.96 | Professional | None | $323.59 | $398.11 | $630.96 |
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 $169.82 Median $181.97 Typical High $204.17 | Professional | 52 · Reduced service | $169.82 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $72.44 Typical High $81.28 | Professional | 53 · Discontinued | $69.18 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $269.15 Typical High $309.03 | Professional | 54 · Surgery only | $257.04 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $54.95 Typical High $61.66 | Professional | 55 · Aftercare only | $51.29 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $36.31 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.88 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $251.19 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $239.88 | $251.19 | $288.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $645.65 Typical High $1,174.90 | Professional | 50 · Both sides | $512.86 | $645.65 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $213.80 Median $269.15 Typical High $489.78 | Professional | 62 · Two surgeons | $213.80 | $269.15 | $489.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $67.61 Typical High $125.89 | Professional | 80 · Assistant surgeon | $54.95 | $67.61 | $125.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $60.26 Typical High $109.65 | Professional | AS · PA/NP assist | $47.86 | $60.26 | $109.65 |
Where California sits
The same service costs 5.6 times more in Alaska than in Utah. 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· 46th of 51
$407
AK $1,660UT $295
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.