How much rates vary
Facilitymedian $2,754 · 10th to 90th $525 to $11,749Professionalmedian $661 · 10th to 90th $550 to $4,677
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 $537.03 Median $616.60 Typical High $1,122.02 | Professional | None | $537.03 | $616.60 | $1,122.02 |
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 $616.60 Median $645.65 Typical High $1,698.24 | Professional | None | $616.60 | $645.65 | $1,698.24 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,754.23 Typical High $9,332.54 | Facility | None | $100.00 | $2,754.23 | $9,332.54 |
Blue Shield Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $1,380.38 | Professional | None | $436.52 | $630.96 | $1,380.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $239.88 Median $741.31 Typical High $912.01 | Professional | None | $239.88 | $741.31 | $912.01 |
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 $524.81 Median $616.60 Typical High $1,479.11 | Professional | None | $524.81 | $616.60 | $1,479.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $218.78 | Professional | None | $181.97 | $181.97 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,698.24 | Professional | None | $741.31 | $851.14 | $1,698.24 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $6,025.60 Typical High $6,025.60 | Professional | None | $4,677.35 | $6,025.60 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
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 $524.81 Median $602.56 Typical High $1,513.56 | Professional | None | $524.81 | $602.56 | $1,513.56 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,230.27 Typical High $10,232.93 | Facility | None | $524.81 | $1,230.27 | $10,232.93 |
United Setting Professional Modifier None Typical Low $562.34 Median $933.25 Typical High $2,630.27 | Professional | None | $562.34 | $933.25 | $2,630.27 |
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 $269.15 Median $288.40 Typical High $316.23 | Professional | 52 · Reduced service | $269.15 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $114.82 Typical High $125.89 | Professional | 53 · Discontinued | $107.15 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $436.52 Typical High $467.74 | Professional | 54 · Surgery only | $398.11 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $93.33 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $57.54 Typical High $63.10 | Professional | 56 · Pre-op care only | $53.70 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $407.38 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $371.54 | $407.38 | $436.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $263.03 Median $338.84 Typical High $588.84 | Professional | 62 · Two surgeons | $263.03 | $338.84 | $588.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $87.10 Typical High $151.36 | Professional | 80 · Assistant surgeon | $66.07 | $87.10 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $75.86 Typical High $131.83 | Professional | AS · PA/NP assist | $58.88 | $75.86 | $131.83 |
Where California sits
The same service costs 7.4 times more in Oklahoma than in New York. 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· 43rd of 51
$851
OK $3,802NY $513
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.