How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $41,687Professionalmedian $1,096 · 10th to 90th $794 to $6,607
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 $2,398.83 Median $9,120.11 Typical High $21,379.62 | Facility | None | $2,398.83 | $9,120.11 | $21,379.62 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,778.28 | Professional | None | $794.33 | $912.01 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $9,120.11 Typical High $19,054.61 | Facility | None | $4,897.79 | $9,120.11 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $3,630.78 | Professional | None | $870.96 | $1,148.15 | $3,630.78 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,606.93 | Facility | None | $67.61 | $3,090.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $2,454.71 | Professional | None | $707.95 | $1,000.00 | $2,454.71 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,202.26 | Professional | None | $724.44 | $1,000.00 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $10,000.00 | Facility | None | $660.69 | $1,258.93 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $2,454.71 | Professional | None | $851.14 | $977.24 | $2,454.71 |
Contra Costa Health Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,148.15 | Professional | None | $891.25 | $977.24 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $2,238.72 | Professional | None | $794.33 | $1,000.00 | $2,238.72 |
Lucent Health Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,918.31 | Professional | None | $6,606.93 | $6,606.93 | $6,918.31 |
Molina Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $812.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $2,454.71 | Professional | None | $851.14 | $954.99 | $2,454.71 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $2,691.53 | Professional | None | $724.44 | $954.99 | $2,691.53 |
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 $407.38 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $407.38 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $162.18 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $602.56 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $120.23 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $81.28 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $562.34 | $630.96 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $144.54 Typical High $338.84 | Professional | 80 · Assistant surgeon | $114.82 | $144.54 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $128.82 Typical High $295.12 | Professional | AS · PA/NP assist | $100.00 | $128.82 | $295.12 |
Where California sits
The same service costs 6.3 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· 31st of 51
$1,148
AK $3,715UT $589
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.