How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,148 to $16,596Professionalmedian $501 · 10th to 90th $372 to $3,162
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 $3,235.94 Median $9,120.11 Typical High $19,952.62 | Facility | None | $3,235.94 | $9,120.11 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $676.08 | Professional | None | $407.38 | $436.52 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,511.38 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $1,778.28 | Professional | None | $478.63 | $537.03 | $1,778.28 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,862.09 Typical High $18,620.87 | Facility | None | $100.00 | $1,862.09 | $18,620.87 |
Blue Shield Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $1,071.52 | Professional | None | $302.00 | $426.58 | $1,071.52 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $512.86 | Professional | None | $316.23 | $446.68 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $4,786.30 Typical High $10,000.00 | Facility | None | $1,548.82 | $4,786.30 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $1,202.26 | Professional | None | $407.38 | $467.74 | $1,202.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $549.54 | Professional | None | $251.19 | $457.09 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $1,230.27 | Professional | None | $407.38 | $501.19 | $1,230.27 |
Lucent Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,388.44 | Professional | None | $3,162.28 | $3,162.28 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $4,897.79 Typical High $10,964.78 | Facility | None | $776.25 | $4,897.79 | $10,964.78 |
Providence Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $1,174.90 | Professional | None | $407.38 | $457.09 | $1,174.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $18,620.87 | Facility | None | $2,884.03 | $6,760.83 | $18,620.87 |
United Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $1,258.93 | Professional | None | $331.13 | $457.09 | $1,258.93 |
10 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 $204.17 Median $218.78 Typical High $234.42 | Professional | 52 · Reduced service | $204.17 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $93.33 | Professional | 53 · Discontinued | $81.28 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $354.81 | Professional | 54 · Surgery only | $302.00 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $64.57 Typical High $70.79 | Professional | 55 · Aftercare only | $60.26 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $46.77 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $302.00 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $281.84 | $302.00 | $331.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $630.96 Typical High $1,513.56 | Professional | 50 · Both sides | $478.63 | $630.96 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $199.53 Median $263.03 Typical High $645.65 | Professional | 62 · Two surgeons | $199.53 | $263.03 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $66.07 Typical High $162.18 | Professional | 80 · Assistant surgeon | $51.29 | $66.07 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $44.67 Median $58.88 Typical High $141.25 | Professional | AS · PA/NP assist | $44.67 | $58.88 | $141.25 |
Where California sits
The same service costs 9.5 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· 24th of 51
$692
OK $3,236UT $339
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.