How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,148 to $11,749Professionalmedian $832 · 10th to 90th $646 to $3,388
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 $724.44 Median $794.33 Typical High $1,479.11 | Professional | None | $724.44 | $794.33 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,232.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $2,818.38 | Professional | None | $724.44 | $870.96 | $2,818.38 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,691.53 Typical High $8,709.64 | Facility | None | $100.00 | $2,691.53 | $8,709.64 |
Blue Shield Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,905.46 | Professional | None | $537.03 | $758.58 | $1,905.46 |
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 $645.65 Median $3,981.07 Typical High $7,413.10 | Facility | None | $645.65 | $3,981.07 | $7,413.10 |
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 $660.69 Median $812.83 Typical High $1,000.00 | Professional | None | $660.69 | $812.83 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,949.84 | Professional | None | $660.69 | $812.83 | $1,949.84 |
Lucent Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
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 $3,801.89 Typical High $7,413.10 | Facility | None | $758.58 | $3,801.89 | $7,413.10 |
Providence 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 |
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 $1,318.26 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 $562.34 Median $776.25 Typical High $2,089.30 | Professional | None | $562.34 | $776.25 | $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 $346.74 Median $371.54 Typical High $407.38 | Professional | 52 · Reduced service | $346.74 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $151.36 Typical High $162.18 | Professional | 53 · Discontinued | $141.25 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $562.34 Typical High $616.60 | Professional | 54 · Surgery only | $524.81 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $104.71 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $81.28 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $524.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $489.78 | $524.81 | $575.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $457.09 Typical High $1,047.13 | Professional | 62 · Two surgeons | $371.54 | $457.09 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $114.82 Typical High $269.15 | Professional | 80 · Assistant surgeon | $93.33 | $114.82 | $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 8.7 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· 27th of 51
$1,072
OK $4,365UT $501
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.