How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,288 to $10,715Professionalmedian $1,122 · 10th to 90th $891 to $7,244
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 $954.99 Median $1,071.52 Typical High $1,949.84 | Professional | None | $954.99 | $1,071.52 | $1,949.84 |
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 $1,096.48 Median $1,202.26 Typical High $3,981.07 | Professional | None | $1,096.48 | $1,202.26 | $3,981.07 |
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 $724.44 Median $1,047.13 Typical High $2,511.89 | Professional | None | $724.44 | $1,047.13 | $2,511.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,288.25 | Professional | None | $851.14 | $1,096.48 | $1,288.25 |
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 $912.01 Median $1,071.52 Typical High $2,691.53 | Professional | None | $912.01 | $1,071.52 | $2,691.53 |
Contra Costa Health Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,174.90 | Professional | None | $676.08 | $977.24 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $2,630.27 | Professional | None | $870.96 | $1,096.48 | $2,630.27 |
Lucent Health Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,413.10 | Professional | None | $7,244.36 | $7,244.36 | $7,413.10 |
Molina Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
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 $912.01 Median $1,023.29 Typical High $2,691.53 | Professional | None | $912.01 | $1,023.29 | $2,691.53 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
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 $776.25 Median $1,071.52 Typical High $2,884.03 | Professional | None | $776.25 | $1,071.52 | $2,884.03 |
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 $467.74 Median $501.19 Typical High $537.03 | Professional | 52 · Reduced service | $467.74 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $213.80 | Professional | 53 · Discontinued | $186.21 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $812.83 | Professional | 54 · Surgery only | $691.83 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $162.18 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $107.15 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $691.83 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $645.65 | $691.83 | $758.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $630.96 Typical High $1,412.54 | Professional | 62 · Two surgeons | $501.19 | $630.96 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $158.49 Typical High $363.08 | Professional | 80 · Assistant surgeon | $125.89 | $158.49 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $141.25 Typical High $316.23 | Professional | AS · PA/NP assist | $109.65 | $141.25 | $316.23 |
Where California sits
The same service costs 5.9 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· 31st of 51
$1,318
OK $4,074UT $692
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.