How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,122 to $11,749Professionalmedian $832 · 10th to 90th $617 to $5,248
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 $691.83 Median $741.31 Typical High $2,454.71 | Professional | None | $691.83 | $741.31 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $11,220.18 Typical High $20,417.38 | Facility | None | $5,370.32 | $11,220.18 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $2,884.03 | Professional | None | $776.25 | $870.96 | $2,884.03 |
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 $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 $1,047.13 | Professional | None | $660.69 | $812.83 | $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 $691.83 Median $794.33 Typical High $1,949.84 | Professional | None | $691.83 | $794.33 | $1,949.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $870.96 | Professional | None | $549.54 | $741.31 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,949.84 | Professional | None | $645.65 | $812.83 | $1,949.84 |
Lucent Health Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,495.41 | Professional | None | $5,248.07 | $5,248.07 | $5,495.41 |
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 $741.31 Median $2,630.27 Typical High $6,025.60 | Facility | None | $741.31 | $2,630.27 | $6,025.60 |
Providence Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,949.84 | Professional | None | $691.83 | $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 $1,318.26 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 $575.44 Median $776.25 Typical High $2,089.30 | Professional | None | $575.44 | $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 $398.11 | Professional | 52 · Reduced service | $346.74 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $147.91 Typical High $162.18 | Professional | 53 · Discontinued | $138.04 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $549.54 Typical High $602.56 | Professional | 54 · Surgery only | $512.86 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $81.28 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $478.63 | $512.86 | $562.34 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $457.09 Typical High $1,047.13 | Professional | 62 · Two surgeons | $363.08 | $457.09 | $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 7.2 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· 19th of 51
$1,230
OK $3,802UT $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.