How much rates vary
Facilitymedian $2,951 · 10th to 90th $794 to $10,233Professionalmedian $525 · 10th to 90th $380 to $2,042
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 $398.11 Median $436.52 Typical High $1,000.00 | Professional | None | $398.11 | $436.52 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $8,128.31 Typical High $16,982.44 | Facility | None | $3,890.45 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $1,621.81 | Professional | None | $512.86 | $562.34 | $1,621.81 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,905.46 Typical High $7,413.10 | Facility | None | $100.00 | $1,905.46 | $7,413.10 |
Blue Shield Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $1,096.48 | Professional | None | $309.03 | $446.68 | $1,096.48 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $1,023.29 | Professional | None | $407.38 | $489.78 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,630.27 Typical High $4,466.84 | Facility | None | $645.65 | $2,630.27 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $1,148.15 | Professional | None | $389.05 | $467.74 | $1,148.15 |
Contra Costa Health Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $724.44 | Professional | None | $446.68 | $537.03 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $1,122.02 | Professional | None | $398.11 | $489.78 | $1,122.02 |
Lucent Health Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $2,630.27 Typical High $5,248.07 | Facility | None | $562.34 | $2,630.27 | $5,248.07 |
Providence Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $1,148.15 | Professional | None | $389.05 | $446.68 | $1,148.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,090.30 | $10,964.78 |
United Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $1,258.93 | Professional | None | $331.13 | $457.09 | $1,258.93 |
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 $194.98 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $194.98 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $77.62 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $288.40 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $57.54 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.90 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $309.03 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $269.15 | $309.03 | $309.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $190.55 Median $245.47 Typical High $630.96 | Professional | 62 · Two surgeons | $190.55 | $245.47 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $61.66 Typical High $158.49 | Professional | 80 · Assistant surgeon | $47.86 | $61.66 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $54.95 Typical High $138.04 | Professional | AS · PA/NP assist | $42.66 | $54.95 | $138.04 |
Where California sits
The same service costs 7.1 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
$646
AK $2,042UT $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.