How much rates vary
Facilitymedian $3,548 · 10th to 90th $661 to $28,184Professionalmedian $1,148 · 10th to 90th $933 to $7,943
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 $1,122.02 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,122.02 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,122.02 | Professional | None | $954.99 | $1,000.00 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $9,120.11 Typical High $19,054.61 | Facility | None | $5,495.41 | $9,120.11 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,096.48 | $1,995.26 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $1,995.26 Typical High $5,495.41 | Facility | None | $95.50 | $1,995.26 | $5,495.41 |
Blue Shield Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,412.54 | Professional | None | $794.33 | $1,148.15 | $1,412.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,258.93 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $10,000.00 | Facility | None | $660.69 | $1,258.93 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,122.02 | $1,737.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,258.93 | Professional | None | $912.01 | $1,148.15 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $2,238.72 | Professional | None | $977.24 | $1,071.52 | $2,238.72 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $9,332.54 Typical High $9,332.54 | Professional | None | $7,943.28 | $9,332.54 | $9,332.54 |
Molina Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $831.76 Median $151,356.12 Typical High $251,188.64 | Facility | None | $831.76 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,122.02 | $1,659.59 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
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 $891.25 Median $1,122.02 Typical High $1,737.80 | Professional | None | $891.25 | $1,122.02 | $1,737.80 |
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 $478.63 Median $501.19 Typical High $562.34 | Professional | 52 · Reduced service | $478.63 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $223.87 | Professional | 53 · Discontinued | $190.55 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $851.14 | Professional | 54 · Surgery only | $724.44 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $169.82 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $100.00 Typical High $112.20 | Professional | 56 · Pre-op care only | $95.50 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $794.33 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $724.44 Typical High $1,380.38 | Professional | 62 · Two surgeons | $575.44 | $724.44 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $181.97 Typical High $346.74 | Professional | 80 · Assistant surgeon | $147.91 | $181.97 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $162.18 Typical High $309.03 | Professional | AS · PA/NP assist | $128.82 | $162.18 | $309.03 |
Where California sits
The same service costs 5.6 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· 42nd of 51
$1,148
AK $4,266TX $759
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.