How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,259 to $11,220Professionalmedian $1,175 · 10th to 90th $871 to $4,898
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 $1,096.48 Median $1,174.90 Typical High $3,311.31 | Professional | None | $1,096.48 | $1,174.90 | $3,311.31 |
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 $1,148.15 Median $1,258.93 Typical High $4,073.80 | Professional | None | $1,148.15 | $1,258.93 | $4,073.80 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,691.53 Typical High $8,128.31 | Facility | None | $100.00 | $2,691.53 | $8,128.31 |
Blue Shield Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $2,691.53 | Professional | None | $758.58 | $1,096.48 | $2,691.53 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $1,122.02 | Professional | None | $741.31 | $1,071.52 | $1,122.02 |
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 $977.24 Median $1,122.02 Typical High $2,818.38 | Professional | None | $977.24 | $1,122.02 | $2,818.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $588.84 Median $1,023.29 Typical High $1,230.27 | Professional | None | $588.84 | $1,023.29 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $2,691.53 | Professional | None | $912.01 | $1,148.15 | $2,691.53 |
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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $977.24 Median $1,096.48 Typical High $2,818.38 | Professional | None | $977.24 | $1,096.48 | $2,818.38 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
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 $794.33 Median $1,122.02 Typical High $2,951.21 | Professional | None | $794.33 | $1,122.02 | $2,951.21 |
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 $524.81 Median $588.84 Typical High $645.65 | Professional | 52 · Reduced service | $524.81 | $588.84 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $234.42 Typical High $257.04 | Professional | 53 · Discontinued | $213.80 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $870.96 Typical High $954.99 | Professional | 54 · Surgery only | $794.33 | $870.96 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $173.78 Typical High $190.55 | Professional | 55 · Aftercare only | $158.49 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $117.49 Typical High $128.82 | Professional | 56 · Pre-op care only | $107.15 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $812.83 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $741.31 | $812.83 | $891.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $676.08 Typical High $1,479.11 | Professional | 62 · Two surgeons | $524.81 | $676.08 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $169.82 Typical High $380.19 | Professional | 80 · Assistant surgeon | $131.83 | $169.82 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $147.91 Typical High $331.13 | Professional | AS · PA/NP assist | $114.82 | $147.91 | $331.13 |
Where California sits
The same service costs 5.6 times more in Alaska 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· 33rd of 51
$1,318
AK $4,074UT $724
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.