How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,122 to $15,849Professionalmedian $891 · 10th to 90th $708 to $5,888
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 $3,019.95 Median $8,912.51 Typical High $19,498.45 | Facility | None | $3,019.95 | $8,912.51 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,122.02 | Professional | None | $758.58 | $831.76 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $11,220.18 Typical High $20,892.96 | Facility | None | $6,165.95 | $11,220.18 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $3,235.94 | Professional | None | $707.95 | $741.31 | $3,235.94 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $2,398.83 Typical High $10,471.29 | Facility | None | $97.72 | $2,398.83 | $10,471.29 |
Blue Shield Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $2,187.76 | Professional | None | $630.96 | $891.25 | $2,187.76 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,174.90 | Professional | None | $691.83 | $891.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $7,244.36 Typical High $13,182.57 | Facility | None | $758.58 | $7,244.36 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $2,290.87 | Professional | None | $758.58 | $933.25 | $2,290.87 |
Contra Costa Health Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,023.29 | Professional | None | $691.83 | $831.76 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,995.26 | Professional | None | $707.95 | $891.25 | $1,995.26 |
Lucent Health Setting Professional Modifier None Typical Low $5,888.44 Median $6,165.95 Typical High $6,165.95 | Professional | None | $5,888.44 | $6,165.95 | $6,165.95 |
Molina Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $6,918.31 Typical High $12,589.25 | Facility | None | $794.33 | $6,918.31 | $12,589.25 |
Providence Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $2,290.87 | Professional | None | $758.58 | $933.25 | $2,290.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $19,054.61 | Facility | None | $2,884.03 | $6,760.83 | $19,054.61 |
United Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $2,398.83 | Professional | None | $645.65 | $891.25 | $2,398.83 |
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 $371.54 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $371.54 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $151.36 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $562.34 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $75.86 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $524.81 | $575.44 | $575.44 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 59 · Distinct service | $1,445.44 | $1,445.44 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $123.03 Typical High $309.03 | Professional | 80 · Assistant surgeon | $93.33 | $123.03 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $107.15 Typical High $269.15 | Professional | AS · PA/NP assist | $83.18 | $107.15 | $269.15 |
Where California sits
The same service costs 11.0 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· 32nd of 51
$1,096
OK $5,888UT $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.