How much rates vary
Facilitymedian $3,715 · 10th to 90th $891 to $12,589Professionalmedian $741 · 10th to 90th $525 to $4,467
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 $537.03 Median $602.56 Typical High $660.69 | Professional | None | $537.03 | $602.56 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,232.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $2,398.83 | Professional | None | $724.44 | $812.83 | $2,398.83 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $10,471.29 | Facility | None | $100.00 | $2,137.96 | $10,471.29 |
Blue Shield Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $1,621.81 | Professional | None | $457.09 | $645.65 | $1,621.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,258.93 | Professional | None | $562.34 | $691.83 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,388.44 Typical High $6,918.31 | Facility | None | $758.58 | $3,388.44 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $1,659.59 | Professional | None | $562.34 | $645.65 | $1,659.59 |
Contra Costa Health Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $891.25 | Professional | None | $616.60 | $741.31 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,548.82 | Professional | None | $549.54 | $691.83 | $1,548.82 |
Lucent Health Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,786.30 | Professional | None | $4,466.84 | $4,466.84 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $3,162.28 Typical High $6,456.54 | Facility | None | $691.83 | $3,162.28 | $6,456.54 |
Providence Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $1,659.59 | Professional | None | $562.34 | $645.65 | $1,659.59 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $478.63 Median $645.65 Typical High $1,819.70 | Professional | None | $478.63 | $645.65 | $1,819.70 |
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 $269.15 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $269.15 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $107.15 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $398.11 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $81.28 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $53.70 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $371.54 | $426.58 | $426.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $302.00 Median $389.05 Typical High $891.25 | Professional | 62 · Two surgeons | $302.00 | $389.05 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $95.50 Typical High $223.87 | Professional | 80 · Assistant surgeon | $75.86 | $95.50 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $85.11 Typical High $194.98 | Professional | AS · PA/NP assist | $66.07 | $85.11 | $194.98 |
Where California sits
The same service costs 6.2 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· 23rd of 51
$955
AK $2,512UT $407
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.