How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,000 to $12,589Professionalmedian $813 · 10th to 90th $617 to $3,467
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 $7,585.78 Typical High $18,197.01 | Facility | None | $2,238.72 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $891.25 | Professional | None | $676.08 | $724.44 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $10,000.00 Typical High $18,620.87 | Facility | None | $4,570.88 | $10,000.00 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $2,818.38 | Professional | None | $812.83 | $891.25 | $2,818.38 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,754.23 Typical High $9,120.11 | Facility | None | $100.00 | $2,754.23 | $9,120.11 |
Blue Shield Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,819.70 | Professional | None | $512.86 | $724.44 | $1,819.70 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $933.25 | Professional | None | $616.60 | $794.33 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,691.53 Typical High $5,248.07 | Facility | None | $758.58 | $2,691.53 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,949.84 | Professional | None | $660.69 | $776.25 | $1,949.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $870.96 | Professional | None | $489.78 | $724.44 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,905.46 | Professional | None | $645.65 | $794.33 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
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 $776.25 Median $2,691.53 Typical High $6,606.93 | Facility | None | $776.25 | $2,691.53 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,949.84 | Professional | None | $660.69 | $758.58 | $1,949.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,365.16 | $14,454.40 |
United Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $2,089.30 | Professional | None | $549.54 | $758.58 | $2,089.30 |
8 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 $338.84 Median $363.08 Typical High $389.05 | Professional | 52 · Reduced service | $338.84 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $154.88 | Professional | 53 · Discontinued | $134.90 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $549.54 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $549.54 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $109.65 Typical High $117.49 | Professional | 55 · Aftercare only | $100.00 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $77.62 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $512.86 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $467.74 | $512.86 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $117.49 Typical High $263.03 | Professional | 80 · Assistant surgeon | $91.20 | $117.49 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $102.33 Typical High $229.09 | Professional | AS · PA/NP assist | $81.28 | $102.33 | $229.09 |
Where California sits
The same service costs 5.8 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· 28th of 51
$1,023
AK $2,818UT $490
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.