How much rates vary
Facilitymedian $4,677 · 10th to 90th $871 to $27,542Professionalmedian $676 · 10th to 90th $457 to $2,630
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 $489.78 Median $549.54 Typical High $2,818.38 | Professional | None | $489.78 | $549.54 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $10,232.93 Typical High $21,379.62 | Facility | None | $6,025.60 | $10,232.93 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $2,187.76 | Professional | None | $562.34 | $707.95 | $2,187.76 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $1,778.28 Typical High $5,128.61 | Facility | None | $95.50 | $1,778.28 | $5,128.61 |
Blue Shield Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $1,348.96 | Professional | None | $389.05 | $549.54 | $1,348.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $741.31 | Professional | None | $467.74 | $645.65 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,258.93 Typical High $10,000.00 | Facility | None | $645.65 | $1,258.93 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $1,479.11 | Professional | None | $489.78 | $575.44 | $1,479.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $691.83 | Professional | None | $436.52 | $588.84 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $1,445.44 | Professional | None | $512.86 | $645.65 | $1,445.44 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Professional | None | $8,317.64 | $8,317.64 | $8,317.64 |
Molina Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $151,356.12 Typical High $251,188.64 | Facility | None | $660.69 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $1,479.11 | Professional | None | $489.78 | $575.44 | $1,479.11 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,168.69 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,168.69 | $14,454.40 |
United Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $1,621.81 | Professional | None | $426.58 | $588.84 | $1,621.81 |
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 $239.88 Median $269.15 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $97.72 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $363.08 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $72.44 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $338.84 | $380.19 | $380.19 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $269.15 Median $338.84 Typical High $812.83 | Professional | 62 · Two surgeons | $269.15 | $338.84 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $89.13 Typical High $204.17 | Professional | 80 · Assistant surgeon | $67.61 | $89.13 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $75.86 Typical High $177.83 | Professional | AS · PA/NP assist | $60.26 | $75.86 | $177.83 |
Where California sits
The same service costs 6.0 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
$794
AK $2,239UT $372
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.