How much rates vary
Facilitymedian $3,311 · 10th to 90th $871 to $11,482Professionalmedian $562 · 10th to 90th $437 to $3,890
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 $501.19 Median $549.54 Typical High $691.83 | Professional | None | $501.19 | $549.54 | $691.83 |
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 $549.54 Median $616.60 Typical High $1,995.26 | Professional | None | $549.54 | $616.60 | $1,995.26 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,819.70 Typical High $9,332.54 | Facility | None | $100.00 | $1,819.70 | $9,332.54 |
Blue Shield Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $1,230.27 | Professional | None | $346.74 | $501.19 | $1,230.27 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $616.60 | Professional | None | $416.87 | $575.44 | $616.60 |
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 $467.74 Median $537.03 Typical High $1,380.38 | Professional | None | $467.74 | $537.03 | $1,380.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $616.60 | Professional | None | $331.13 | $512.86 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $1,380.38 | Professional | None | $457.09 | $575.44 | $1,380.38 |
Lucent Health Setting Professional Modifier None Typical Low $3,890.45 Median $4,168.69 Typical High $4,168.69 | Professional | None | $3,890.45 | $4,168.69 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $2,754.23 Typical High $6,606.93 | Facility | None | $660.69 | $2,754.23 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $1,348.96 | Professional | None | $467.74 | $524.81 | $1,348.96 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $380.19 Median $537.03 Typical High $1,445.44 | Professional | None | $380.19 | $537.03 | $1,445.44 |
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 $234.42 Median $251.19 Typical High $269.15 | Professional | 52 · Reduced service | $234.42 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $100.00 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $380.19 Typical High $407.38 | Professional | 54 · Surgery only | $346.74 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $75.86 Typical High $81.28 | Professional | 55 · Aftercare only | $70.79 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $46.77 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $354.81 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $323.59 | $354.81 | $380.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $758.58 Typical High $1,737.80 | Professional | 50 · Both sides | $602.56 | $758.58 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $81.28 Typical High $186.21 | Professional | 80 · Assistant surgeon | $64.57 | $81.28 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $70.79 Typical High $162.18 | Professional | AS · PA/NP assist | $56.23 | $70.79 | $162.18 |
Where California sits
The same service costs 10.0 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· 30th of 51
$724
OK $3,631UT $363
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.