How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,047 to $27,542Professionalmedian $1,072 · 10th to 90th $759 to $4,266
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 $2,570.40 Median $8,912.51 Typical High $19,054.61 | Facility | None | $2,570.40 | $8,912.51 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $3,162.28 | Professional | None | $794.33 | $870.96 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $10,232.93 Typical High $21,379.62 | Facility | None | $6,025.60 | $10,232.93 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $3,548.13 | Professional | None | $870.96 | $1,122.02 | $3,548.13 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $1,995.26 Typical High $5,370.32 | Facility | None | $95.50 | $1,995.26 | $5,370.32 |
Blue Shield Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $2,398.83 | Professional | None | $707.95 | $1,023.29 | $2,398.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,202.26 | Professional | None | $707.95 | $977.24 | $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 $812.83 Median $977.24 Typical High $2,454.71 | Professional | None | $812.83 | $977.24 | $2,454.71 |
Contra Costa Health Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,148.15 | Professional | None | $870.96 | $977.24 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $2,187.76 | Professional | None | $794.33 | $1,000.00 | $2,187.76 |
Lucent Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
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 $812.83 Median $933.25 Typical High $2,454.71 | Professional | None | $812.83 | $933.25 | $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 $1,659.59 Median $4,168.69 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,168.69 | $14,454.40 |
United Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $2,630.27 | Professional | None | $707.95 | $954.99 | $2,630.27 |
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 $389.05 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $389.05 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $154.88 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $588.84 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $117.49 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $77.62 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $549.54 | $602.56 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,348.96 Typical High $3,162.28 | Professional | 50 · Both sides | $1,071.52 | $1,348.96 | $3,162.28 |
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 $125.89 Typical High $295.12 | Professional | AS · PA/NP assist | $100.00 | $125.89 | $295.12 |
Where California sits
The same service costs 6.5 times more in Alaska than in Texas. 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· 25th of 51
$1,259
AK $3,715TX $575
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.