How much rates vary
Facilitymedian $4,074 · 10th to 90th $813 to $11,220Professionalmedian $457 · 10th to 90th $324 to $1,445
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 $2,137.96 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,137.96 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $691.83 | Professional | None | $338.84 | $389.05 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,511.38 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $1,288.25 | Professional | None | $398.11 | $478.63 | $1,288.25 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,398.83 Typical High $8,317.64 | Facility | None | $100.00 | $2,398.83 | $8,317.64 |
Blue Shield Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $1,023.29 | Professional | None | $323.59 | $457.09 | $1,023.29 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $467.74 | Professional | None | $269.15 | $331.13 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,388.44 Typical High $6,606.93 | Facility | None | $645.65 | $3,388.44 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $891.25 | Professional | None | $354.81 | $407.38 | $891.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $380.19 | Professional | None | $275.42 | $323.59 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $794.33 | Professional | None | $269.15 | $338.84 | $794.33 |
Lucent Health Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Providence Setting Facility Modifier None Typical Low $549.54 Median $3,311.31 Typical High $7,585.78 | Facility | None | $549.54 | $3,311.31 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $891.25 | Professional | None | $346.74 | $407.38 | $891.25 |
Sutter Health Plus Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Facility | None | $6,456.54 | $6,456.54 | $6,456.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,677.35 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,677.35 | $14,454.40 |
United Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $954.99 | Professional | None | $257.04 | $346.74 | $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 $173.78 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $173.78 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $69.18 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $51.29 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $34.67 | $38.90 | $38.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $138.04 Median $181.97 Typical High $501.19 | Professional | 62 · Two surgeons | $138.04 | $181.97 | $501.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $35.48 Median $46.77 Typical High $125.89 | Professional | 80 · Assistant surgeon | $35.48 | $46.77 | $125.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $30.90 Median $40.74 Typical High $104.71 | Professional | AS · PA/NP assist | $30.90 | $40.74 | $104.71 |
Where California sits
The same service costs 10.0 times more in Oklahoma than in New York. 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· 37th of 51
$479
OK $2,884NY $288
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.