How much rates vary
Facilitymedian $2,399 · 10th to 90th $525 to $10,000Professionalmedian $490 · 10th to 90th $355 to $1,905
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 $2,238.72 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,238.72 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $602.56 | Professional | None | $363.08 | $416.87 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $10,000.00 Typical High $18,620.87 | Facility | None | $4,570.88 | $10,000.00 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $1,584.89 | Professional | None | $489.78 | $549.54 | $1,584.89 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,089.30 Typical High $6,025.60 | Facility | None | $100.00 | $2,089.30 | $6,025.60 |
Blue Shield Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $1,071.52 | Professional | None | $302.00 | $436.52 | $1,071.52 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $1,023.29 | Professional | None | $398.11 | $489.78 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,630.27 Typical High $5,370.32 | Facility | None | $758.58 | $2,630.27 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $1,122.02 | Professional | None | $380.19 | $446.68 | $1,122.02 |
Contra Costa Health Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $724.44 | Professional | None | $436.52 | $524.81 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $1,000.00 | Professional | None | $389.05 | $478.63 | $1,000.00 |
Lucent Health Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
Molina Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $2,570.40 Typical High $5,248.07 | Facility | None | $616.60 | $2,570.40 | $5,248.07 |
Providence Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $1,122.02 | Professional | None | $380.19 | $436.52 | $1,122.02 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
United Setting Facility Modifier None Typical Low $524.81 Median $933.25 Typical High $7,585.78 | Facility | None | $524.81 | $933.25 | $7,585.78 |
United Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $1,230.27 | Professional | None | $323.59 | $446.68 | $1,230.27 |
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 $181.97 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $181.97 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $72.44 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $269.15 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $53.70 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $288.40 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $251.19 | $288.40 | $288.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $199.53 Median $257.04 Typical High $616.60 | Professional | 62 · Two surgeons | $199.53 | $257.04 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $64.57 Typical High $154.88 | Professional | 80 · Assistant surgeon | $51.29 | $64.57 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $44.67 Median $56.23 Typical High $134.90 | Professional | AS · PA/NP assist | $44.67 | $56.23 | $134.90 |
Where California sits
The same service costs 10.2 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· 34th of 51
$550
OK $2,951UT $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.