How much rates vary
Facilitymedian $2,692 · 10th to 90th $603 to $7,943Professionalmedian $398 · 10th to 90th $302 to $1,698
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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $1,584.89 | Professional | None | $323.59 | $346.74 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,128.61 Typical High $10,471.29 | Facility | None | $2,137.96 | $5,128.61 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $1,445.44 | Professional | None | $389.05 | $426.58 | $1,445.44 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,778.28 Typical High $5,495.41 | Facility | None | $100.00 | $1,778.28 | $5,495.41 |
Blue Shield Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $870.96 | Professional | None | $245.47 | $354.81 | $870.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $338.84 Median $741.31 Typical High $1,412.54 | Professional | None | $338.84 | $741.31 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $2,511.89 Typical High $5,011.87 | Facility | None | $426.58 | $2,511.89 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $977.24 | Professional | None | $338.84 | $380.19 | $977.24 |
Contra Costa Health Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $933.25 | Professional | None | $371.54 | $489.78 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $954.99 | Professional | None | $331.13 | $407.38 | $954.99 |
Lucent Health Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
Molina Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $2,454.71 Typical High $5,011.87 | Facility | None | $426.58 | $2,454.71 | $5,011.87 |
Providence Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $977.24 | Professional | None | $338.84 | $371.54 | $977.24 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,090.30 | $10,964.78 |
United Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $1,023.29 | Professional | None | $275.42 | $380.19 | $1,023.29 |
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 $162.18 Median $173.78 Typical High $190.55 | Professional | 52 · Reduced service | $162.18 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $75.86 | Professional | 53 · Discontinued | $64.57 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $263.03 Typical High $288.40 | Professional | 54 · Surgery only | $245.47 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $48.98 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $34.67 Typical High $38.02 | Professional | 56 · Pre-op care only | $32.36 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $245.47 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $229.09 | $245.47 | $269.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $501.19 Typical High $1,230.27 | Professional | 50 · Both sides | $389.05 | $501.19 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $53.70 Typical High $131.83 | Professional | 80 · Assistant surgeon | $40.74 | $53.70 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $46.77 Typical High $114.82 | Professional | AS · PA/NP assist | $36.31 | $46.77 | $114.82 |
Where California sits
The same service costs 6.9 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· 27th of 51
$525
AK $1,905UT $275
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.