How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,230 to $10,233Professionalmedian $1,072 · 10th to 90th $813 to $4,467
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 $891.25 Median $954.99 Typical High $2,884.03 | Professional | None | $891.25 | $954.99 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $8,128.31 Typical High $16,982.44 | Facility | None | $3,890.45 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $3,890.45 | Professional | None | $1,047.13 | $1,122.02 | $3,890.45 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,691.53 Typical High $7,585.78 | Facility | None | $100.00 | $2,691.53 | $7,585.78 |
Blue Shield Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $2,454.71 | Professional | None | $707.95 | $1,000.00 | $2,454.71 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,288.25 | Professional | None | $851.14 | $1,071.52 | $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 $891.25 Median $1,047.13 Typical High $2,630.27 | Professional | None | $891.25 | $1,047.13 | $2,630.27 |
Contra Costa Health Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,148.15 | Professional | None | $676.08 | $954.99 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $2,511.89 | Professional | None | $851.14 | $1,071.52 | $2,511.89 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Professional | None | $8,317.64 | $8,317.64 | $8,317.64 |
Molina Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $891.25 Median $1,000.00 Typical High $2,630.27 | Professional | None | $891.25 | $1,000.00 | $2,630.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
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 $741.31 Median $1,023.29 Typical High $2,754.23 | Professional | None | $741.31 | $1,023.29 | $2,754.23 |
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 $446.68 Median $478.63 Typical High $512.86 | Professional | 52 · Reduced service | $446.68 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $204.17 | Professional | 53 · Discontinued | $177.83 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $154.88 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $102.33 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $707.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $616.60 Typical High $1,380.38 | Professional | 62 · Two surgeons | $489.78 | $616.60 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $154.88 Typical High $354.81 | Professional | 80 · Assistant surgeon | $123.03 | $154.88 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $138.04 Typical High $309.03 | Professional | AS · PA/NP assist | $107.15 | $138.04 | $309.03 |
Where California sits
The same service costs 6.2 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· 31st of 51
$1,318
OK $4,074UT $661
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.