How much rates vary
Facilitymedian $4,169 · 10th to 90th $955 to $21,380Professionalmedian $871 · 10th to 90th $676 to $3,548
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 $6,760.83 Typical High $16,218.10 | Facility | None | $2,238.72 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,122.02 | Professional | None | $776.25 | $831.76 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $7,585.78 Typical High $16,595.87 | Facility | None | $4,570.88 | $7,585.78 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $3,090.30 | Professional | None | $851.14 | $933.25 | $3,090.30 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $1,778.28 Typical High $5,128.61 | Facility | None | $95.50 | $1,778.28 | $5,128.61 |
Blue Shield Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,995.26 | Professional | None | $562.34 | $794.33 | $1,995.26 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,412.54 | Professional | None | $707.95 | $870.96 | $1,412.54 |
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 $724.44 Median $851.14 Typical High $2,089.30 | Professional | None | $724.44 | $851.14 | $2,089.30 |
Contra Costa Health Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,047.13 | Professional | None | $741.31 | $870.96 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,737.80 | Professional | None | $691.83 | $870.96 | $1,737.80 |
Lucent Health Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Professional | None | $6,456.54 | $6,456.54 | $6,456.54 |
Molina Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $812.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $2,089.30 | Professional | None | $724.44 | $812.83 | $2,089.30 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,019.95 Typical High $10,964.78 | Facility | None | $1,230.27 | $3,019.95 | $10,964.78 |
United Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $2,238.72 | Professional | None | $616.60 | $870.96 | $2,238.72 |
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 $380.19 Median $407.38 Typical High $426.58 | Professional | 52 · Reduced service | $380.19 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $162.18 Typical High $169.82 | Professional | 53 · Discontinued | $151.36 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $630.96 | Professional | 54 · Surgery only | $575.44 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $125.89 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $81.28 Typical High $85.11 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $588.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $512.86 Typical High $1,122.02 | Professional | 62 · Two surgeons | $398.11 | $512.86 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $125.89 Typical High $288.40 | Professional | 80 · Assistant surgeon | $100.00 | $125.89 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $109.65 Typical High $251.19 | Professional | AS · PA/NP assist | $87.10 | $109.65 | $251.19 |
Where California sits
The same service costs 5.9 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· 30th of 51
$1,047
AK $3,090TX $525
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.