How much rates vary
Facilitymedian $3,020 · 10th to 90th $759 to $10,233Professionalmedian $380 · 10th to 90th $275 to $2,399
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 $6,760.83 Typical High $16,218.10 | Facility | None | $2,238.72 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $489.78 | Professional | None | $275.42 | $316.23 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $8,128.31 Typical High $16,982.44 | Facility | None | $3,890.45 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $1,230.27 | Professional | None | $363.08 | $398.11 | $1,230.27 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $7,413.10 | Facility | None | $100.00 | $2,137.96 | $7,413.10 |
Blue Shield Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $831.76 | Professional | None | $234.42 | $331.13 | $831.76 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $512.86 | Professional | None | $302.00 | $389.05 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,630.27 Typical High $4,466.84 | Facility | None | $645.65 | $2,630.27 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $870.96 | Professional | None | $288.40 | $346.74 | $870.96 |
Contra Costa Health Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $457.09 | Professional | None | $302.00 | $363.08 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $933.25 | Professional | None | $309.03 | $380.19 | $933.25 |
Lucent Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,570.40 | Professional | None | $2,398.83 | $2,398.83 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Providence Setting Facility Modifier None Typical Low $524.81 Median $2,630.27 Typical High $5,248.07 | Facility | None | $524.81 | $2,630.27 | $5,248.07 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $870.96 | Professional | None | $288.40 | $331.13 | $870.96 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
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 $251.19 Median $354.81 Typical High $954.99 | Professional | None | $251.19 | $354.81 | $954.99 |
8 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 $138.04 Median $154.88 Typical High $158.49 | Professional | 52 · Reduced service | $138.04 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $54.95 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $41.69 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $27.54 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $194.98 | $218.78 | $218.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $36.31 Median $46.77 Typical High $120.23 | Professional | 80 · Assistant surgeon | $36.31 | $46.77 | $120.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $40.74 Typical High $107.15 | Professional | AS · PA/NP assist | $31.62 | $40.74 | $107.15 |
Where California sits
The same service costs 11.2 times more in Oklahoma 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
$490
OK $2,512UT $224
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.