How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,047 to $14,791Professionalmedian $871 · 10th to 90th $631 to $3,467
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 $3,090.30 Median $9,120.11 Typical High $19,498.45 | Facility | None | $3,090.30 | $9,120.11 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $4,265.80 | Professional | None | $660.69 | $741.31 | $4,265.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $11,748.98 Typical High $21,379.62 | Facility | None | $6,025.60 | $11,748.98 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $2,951.21 | Professional | None | $724.44 | $912.01 | $2,951.21 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,454.71 Typical High $10,964.78 | Facility | None | $100.00 | $2,454.71 | $10,964.78 |
Blue Shield Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,995.26 | Professional | None | $602.56 | $870.96 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,570.88 Typical High $10,000.00 | Facility | None | $851.14 | $4,570.88 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,995.26 | Professional | None | $676.08 | $812.83 | $1,995.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $954.99 | Professional | None | $707.95 | $776.25 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,862.09 | Professional | None | $630.96 | $794.33 | $1,862.09 |
Lucent Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | None | $7,413.10 | $7,413.10 | $7,413.10 |
Molina Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $4,466.84 Typical High $10,000.00 | Facility | None | $794.33 | $4,466.84 | $10,000.00 |
Providence Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,949.84 | Professional | None | $676.08 | $776.25 | $1,949.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $18,620.87 | Facility | None | $2,884.03 | $6,760.83 | $18,620.87 |
United Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $2,137.96 | Professional | None | $575.44 | $776.25 | $2,137.96 |
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 $323.59 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $131.83 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $489.78 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $97.72 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $66.07 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $457.09 | $512.86 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,047.13 Typical High $2,630.27 | Professional | 50 · Both sides | $794.33 | $1,047.13 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $109.65 Typical High $281.84 | Professional | 80 · Assistant surgeon | $85.11 | $109.65 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $97.72 Typical High $245.47 | Professional | AS · PA/NP assist | $74.13 | $97.72 | $245.47 |
Where California sits
The same service costs 6.5 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· 28th of 51
$1,096
AK $3,467UT $537
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.