How much rates vary
Facilitymedian $4,677 · 10th to 90th $955 to $38,905Professionalmedian $1,096 · 10th to 90th $1,096 to $1,380
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 $3,090.30 Median $9,120.11 Typical High $19,498.45 | Facility | None | $3,090.30 | $9,120.11 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,380.38 | Professional | None | $1,096.48 | $1,096.48 | $1,380.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,413.10 Median $9,772.37 Typical High $13,182.57 | Facility | None | $7,413.10 | $9,772.37 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $977.24 | Professional | None | $660.69 | $776.25 | $977.24 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $14,454.40 | Facility | None | $100.00 | $2,137.96 | $14,454.40 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,479.11 Typical High $14,791.08 | Facility | None | $660.69 | $1,479.11 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $630.96 Typical High $831.76 | Professional | None | $128.82 | $630.96 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,715.35 Typical High $3,715.35 | Professional | None | $2,630.27 | $3,715.35 | $3,715.35 |
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 $776.25 Median $151,356.12 Typical High $251,188.64 | Facility | None | $776.25 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $89.13 | Professional | None | $60.26 | $79.43 | $89.13 |
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 $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
4 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,174.90 Typical High $1,445.44 | Professional | 50 · Both sides | $1,000.00 | $1,174.90 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $489.78 Typical High $602.56 | Professional | 62 · Two surgeons | $416.87 | $489.78 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $125.89 Typical High $154.88 | Professional | 80 · Assistant surgeon | $107.15 | $125.89 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $109.65 Typical High $134.90 | Professional | AS · PA/NP assist | $93.33 | $109.65 | $134.90 |
Where California sits
The same service costs 104.7 times more in Wisconsin 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.
California· 15th of 51
$1,148
WI $8,318MT $79.43
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.