How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,175 to $11,220Professionalmedian $955 · 10th to 90th $741 to $3,890
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 $794.33 Median $851.14 Typical High $1,174.90 | Professional | None | $794.33 | $851.14 | $1,174.90 |
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 $933.25 Median $1,000.00 Typical High $3,388.44 | Professional | None | $933.25 | $1,000.00 | $3,388.44 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,691.53 Typical High $7,943.28 | Facility | None | $100.00 | $2,691.53 | $7,943.28 |
Blue Shield Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $2,187.76 | Professional | None | $630.96 | $891.25 | $2,187.76 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,380.38 | Professional | None | $758.58 | $933.25 | $1,380.38 |
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 $776.25 Median $912.01 Typical High $2,290.87 | Professional | None | $776.25 | $912.01 | $2,290.87 |
Contra Costa Health Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,122.02 | Professional | None | $741.31 | $912.01 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $2,238.72 | Professional | None | $741.31 | $933.25 | $2,238.72 |
Lucent Health Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Professional | None | $7,762.47 | $7,762.47 | $7,762.47 |
Molina Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
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 $776.25 Median $891.25 Typical High $2,290.87 | Professional | None | $776.25 | $891.25 | $2,290.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $10,232.93 | Facility | None | $1,318.26 | $1,318.26 | $10,232.93 |
United Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $2,398.83 | Professional | None | $660.69 | $912.01 | $2,398.83 |
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 $398.11 Median $426.58 Typical High $467.74 | Professional | 52 · Reduced service | $398.11 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $186.21 | Professional | 53 · Discontinued | $158.49 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $645.65 Typical High $691.83 | Professional | 54 · Surgery only | $602.56 | $645.65 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $128.82 Typical High $138.04 | Professional | 55 · Aftercare only | $120.23 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $85.11 Typical High $93.33 | Professional | 56 · Pre-op care only | $79.43 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $602.56 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $562.34 | $602.56 | $645.65 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $549.54 Typical High $1,202.26 | Professional | 62 · Two surgeons | $416.87 | $549.54 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $138.04 Typical High $309.03 | Professional | 80 · Assistant surgeon | $107.15 | $138.04 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $120.23 Typical High $269.15 | Professional | AS · PA/NP assist | $93.33 | $120.23 | $269.15 |
Where California sits
The same service costs 6.6 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· 25th of 51
$1,202
OK $3,802UT $575
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.