How much rates vary
Facilitymedian $5,623 · 10th to 90th $851 to $38,905Professionalmedian $832 · 10th to 90th $617 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 $933.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $831.76 | Professional | None | $724.44 | $758.58 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $8,709.64 Typical High $17,782.79 | Facility | None | $5,370.32 | $8,709.64 | $17,782.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $2,884.03 | Professional | None | $812.83 | $891.25 | $2,884.03 |
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 $524.81 Median $758.58 Typical High $1,862.09 | Professional | None | $524.81 | $758.58 | $1,862.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,258.93 | Professional | None | $660.69 | $812.83 | $1,258.93 |
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 $676.08 Median $794.33 Typical High $1,949.84 | Professional | None | $676.08 | $794.33 | $1,949.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $977.24 | Professional | None | $676.08 | $812.83 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,659.59 | Professional | None | $645.65 | $812.83 | $1,659.59 |
Lucent Health Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Professional | None | $6,309.57 | $6,309.57 | $6,309.57 |
Molina Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $151,356.12 Typical High $251,188.64 | Facility | None | $758.58 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,949.84 | Professional | None | $676.08 | $758.58 | $1,949.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,019.95 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,019.95 | $10,964.78 |
United Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $2,089.30 | Professional | None | $562.34 | $812.83 | $2,089.30 |
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 $354.81 Median $380.19 Typical High $398.11 | Professional | 52 · Reduced service | $354.81 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $154.88 Typical High $158.49 | Professional | 53 · Discontinued | $144.54 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $575.44 Typical High $602.56 | Professional | 54 · Surgery only | $537.03 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $114.82 Typical High $120.23 | Professional | 55 · Aftercare only | $107.15 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $75.86 Typical High $79.43 | Professional | 56 · Pre-op care only | $70.79 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $537.03 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $501.19 | $537.03 | $562.34 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $467.74 Typical High $1,047.13 | Professional | 62 · Two surgeons | $363.08 | $467.74 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $117.49 Typical High $269.15 | Professional | 80 · Assistant surgeon | $93.33 | $117.49 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $102.33 Typical High $234.42 | Professional | AS · PA/NP assist | $81.28 | $102.33 | $234.42 |
Where California sits
The same service costs 5.4 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· 32nd of 51
$955
AK $2,884UT $537
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.