How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $56,234Professionalmedian $1,096 · 10th to 90th $832 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 $1,071.52 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,071.52 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,096.48 | Professional | None | $954.99 | $1,023.29 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $11,220.18 Typical High $22,387.21 | Facility | None | $6,760.83 | $11,220.18 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $3,801.89 | Professional | None | $1,071.52 | $1,202.26 | $3,801.89 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,606.93 | Facility | None | $67.61 | $3,090.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $2,511.89 | Professional | None | $724.44 | $1,023.29 | $2,511.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,445.44 | Professional | None | $870.96 | $1,071.52 | $1,445.44 |
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 $891.25 Median $1,047.13 Typical High $2,630.27 | Professional | None | $891.25 | $1,047.13 | $2,630.27 |
Contra Costa Health Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,174.90 | Professional | None | $776.25 | $977.24 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $2,137.96 | Professional | None | $851.14 | $1,071.52 | $2,137.96 |
Lucent Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | None | $7,413.10 | $7,413.10 | $7,413.10 |
Molina Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $151,356.12 Typical High $251,188.64 | Facility | None | $851.14 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $2,630.27 | Professional | None | $891.25 | $1,000.00 | $2,630.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
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 $741.31 Median $1,071.52 Typical High $2,818.38 | Professional | None | $741.31 | $1,071.52 | $2,818.38 |
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 $478.63 Median $512.86 Typical High $524.81 | Professional | 52 · Reduced service | $478.63 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $213.80 | Professional | 53 · Discontinued | $190.55 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $794.33 | Professional | 54 · Surgery only | $707.95 | $758.58 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $158.49 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $107.15 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $707.95 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $660.69 | $707.95 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,479.11 Typical High $3,311.31 | Professional | 50 · Both sides | $1,148.15 | $1,479.11 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $616.60 Typical High $1,380.38 | Professional | 62 · Two surgeons | $489.78 | $616.60 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $158.49 Typical High $354.81 | Professional | 80 · Assistant surgeon | $123.03 | $158.49 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $138.04 Typical High $309.03 | Professional | AS · PA/NP assist | $107.15 | $138.04 | $309.03 |
Where California sits
The same service costs 7.9 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· 33rd of 51
$1,202
AK $3,802TX $479
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.