How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,000 to $12,882Professionalmedian $871 · 10th to 90th $617 to $5,370
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 $2,818.38 Median $8,912.51 Typical High $19,498.45 | Facility | None | $2,818.38 | $8,912.51 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,047.13 | Professional | None | $616.60 | $707.95 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,011.87 Typical High $9,549.93 | Facility | None | $2,137.96 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $2,818.38 | Professional | None | $851.14 | $912.01 | $2,818.38 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $14,454.40 | Facility | None | $100.00 | $2,137.96 | $14,454.40 |
Blue Shield Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $1,819.70 | Professional | None | $512.86 | $741.31 | $1,819.70 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,023.29 | Professional | None | $616.60 | $851.14 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,630.27 Typical High $5,495.41 | Facility | None | $758.58 | $2,630.27 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,905.46 | Professional | None | $630.96 | $758.58 | $1,905.46 |
Contra Costa Health Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $912.01 | Professional | None | $602.56 | $758.58 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,905.46 | Professional | None | $660.69 | $831.76 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,623.41 | Professional | None | $5,370.32 | $5,370.32 | $5,623.41 |
Molina Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $2,570.40 Typical High $5,370.32 | Facility | None | $758.58 | $2,570.40 | $5,370.32 |
Providence Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,905.46 | Professional | None | $630.96 | $741.31 | $1,905.46 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,466.84 Typical High $14,791.08 | Facility | None | $1,659.59 | $4,466.84 | $14,791.08 |
United Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $2,137.96 | Professional | None | $562.34 | $776.25 | $2,137.96 |
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 $309.03 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $309.03 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $123.03 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $467.74 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $93.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $61.66 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $436.52 | $489.78 | $489.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $436.52 Typical High $1,047.13 | Professional | 62 · Two surgeons | $346.74 | $436.52 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $112.20 Typical High $269.15 | Professional | 80 · Assistant surgeon | $87.10 | $112.20 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $97.72 Typical High $234.42 | Professional | AS · PA/NP assist | $75.86 | $97.72 | $234.42 |
Where California sits
The same service costs 4.2 times more in Oklahoma than in Kentucky. 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.
Physician feeFacility fee
OK $7,810KY $1,873
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.