How much rates vary
Facilitymedian $3,548 · 10th to 90th $646 to $23,442Professionalmedian $398 · 10th to 90th $288 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 $1,905.46 Median $6,165.95 Typical High $15,848.93 | Facility | None | $1,905.46 | $6,165.95 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $478.63 | Professional | None | $302.00 | $338.84 | $478.63 |
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 $380.19 Median $436.52 Typical High $1,318.26 | Professional | None | $380.19 | $436.52 | $1,318.26 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $1,778.28 Typical High $5,128.61 | Facility | None | $95.50 | $1,778.28 | $5,128.61 |
Blue Shield Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $891.25 | Professional | None | $263.03 | $380.19 | $891.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $758.58 | Professional | None | $309.03 | $380.19 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,258.93 Typical High $10,000.00 | Facility | None | $676.08 | $1,258.93 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $912.01 | Professional | None | $309.03 | $363.08 | $912.01 |
Contra Costa Health Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $524.81 | Professional | None | $338.84 | $407.38 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $912.01 | Professional | None | $309.03 | $380.19 | $912.01 |
Lucent Health 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 |
Molina Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Providence Setting Facility Modifier None Typical Low $524.81 Median $151,356.12 Typical High $251,188.64 | Facility | None | $524.81 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $912.01 | Professional | None | $309.03 | $346.74 | $912.01 |
Sutter Health Plus 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 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $977.24 | Professional | None | $263.03 | $354.81 | $977.24 |
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 $147.91 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $147.91 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $58.88 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $218.78 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $44.67 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $29.51 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $234.42 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $204.17 | $234.42 | $234.42 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $41.69 Median $52.48 Typical High $123.03 | Professional | 80 · Assistant surgeon | $41.69 | $52.48 | $123.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $46.77 Typical High $107.15 | Professional | AS · PA/NP assist | $36.31 | $46.77 | $107.15 |
Where California sits
The same service costs 5.8 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· 32nd of 51
$447
AK $1,380UT $240
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.