How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,148 to $10,715Professionalmedian $871 · 10th to 90th $692 to $5,623
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 $17,782.79 | Facility | None | $2,238.72 | $6,760.83 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,513.56 | Professional | None | $707.95 | $776.25 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,128.31 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $3,090.30 | Professional | None | $870.96 | $954.99 | $3,090.30 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,691.53 Typical High $8,912.51 | Facility | None | $100.00 | $2,691.53 | $8,912.51 |
Blue Shield Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $1,949.84 | Professional | None | $562.34 | $812.83 | $1,949.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,047.13 | Professional | None | $691.83 | $851.14 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,630.27 Typical High $5,248.07 | Facility | None | $645.65 | $2,630.27 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $2,089.30 | Professional | None | $707.95 | $831.76 | $2,089.30 |
Contra Costa Health Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $912.01 | Professional | None | $562.34 | $758.58 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $2,041.74 | Professional | None | $676.08 | $851.14 | $2,041.74 |
Lucent Health Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,754.40 | Professional | None | $5,623.41 | $5,623.41 | $5,754.40 |
Molina Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $2,630.27 Typical High $6,025.60 | Facility | None | $758.58 | $2,630.27 | $6,025.60 |
Providence Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $2,089.30 | Professional | None | $707.95 | $812.83 | $2,089.30 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $12,589.25 | Facility | None | $1,318.26 | $1,659.59 | $12,589.25 |
United Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $2,187.76 | Professional | None | $588.84 | $831.76 | $2,187.76 |
8 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 $363.08 Median $389.05 Typical High $416.87 | Professional | 52 · Reduced service | $363.08 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $154.88 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $575.44 Typical High $630.96 | Professional | 54 · Surgery only | $537.03 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $114.82 Typical High $125.89 | Professional | 55 · Aftercare only | $107.15 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $77.62 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $537.03 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $501.19 | $537.03 | $588.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $123.03 Typical High $281.84 | Professional | 80 · Assistant surgeon | $97.72 | $123.03 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $109.65 Typical High $245.47 | Professional | AS · PA/NP assist | $85.11 | $109.65 | $245.47 |
Where California sits
The same service costs 7.9 times more in Oklahoma 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· 26th of 51
$1,148
OK $4,169UT $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.