How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,000 to $13,804Professionalmedian $955 · 10th to 90th $646 to $3,631
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 $933.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $776.25 | Professional | None | $676.08 | $758.58 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $12,302.69 Typical High $21,379.62 | Facility | None | $6,025.60 | $12,302.69 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $3,090.30 | Professional | None | $954.99 | $1,000.00 | $3,090.30 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $2,187.76 Typical High $10,715.19 | Facility | None | $97.72 | $2,187.76 | $10,715.19 |
Blue Shield Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $2,041.74 | Professional | None | $575.44 | $831.76 | $2,041.74 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,096.48 | Professional | None | $645.65 | $870.96 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,786.30 Typical High $7,943.28 | Facility | None | $758.58 | $4,786.30 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $2,089.30 | Professional | None | $691.83 | $831.76 | $2,089.30 |
Contra Costa Health Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $977.24 | Professional | None | $645.65 | $776.25 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,905.46 | Professional | None | $691.83 | $870.96 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $4,466.84 Typical High $7,762.47 | Facility | None | $758.58 | $4,466.84 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $2,041.74 | Professional | None | $691.83 | $794.33 | $2,041.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 $588.84 Median $794.33 Typical High $2,238.72 | Professional | None | $588.84 | $794.33 | $2,238.72 |
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 $338.84 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $338.84 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $134.90 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $512.86 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $102.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $67.61 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $537.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $489.78 Typical High $1,148.15 | Professional | 62 · Two surgeons | $380.19 | $489.78 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $125.89 Typical High $288.40 | Professional | 80 · Assistant surgeon | $95.50 | $125.89 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $109.65 Typical High $251.19 | Professional | AS · PA/NP assist | $85.11 | $109.65 | $251.19 |
Where California sits
The same service costs 6.8 times more in Oklahoma than in Texas. 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
$1,096
OK $3,548TX $525
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.