How much rates vary
Facilitymedian $1,318 · 10th to 90th $191 to $6,310Professionalmedian $288 · 10th to 90th $200 to $1,000
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 $478.63 Median $5,128.61 Typical High $15,135.61 | Facility | None | $478.63 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $257.04 | Professional | None | $208.93 | $223.87 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $758.58 | Professional | None | $263.03 | $302.00 | $758.58 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,995.26 Typical High $5,248.07 | Facility | None | $100.00 | $1,995.26 | $5,248.07 |
Blue Shield Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $630.96 | Professional | None | $177.83 | $275.42 | $630.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $331.13 | Professional | None | $186.21 | $223.87 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $346.74 Typical High $812.83 | Facility | None | $223.87 | $346.74 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $1,479.11 | Professional | None | $208.93 | $281.84 | $1,479.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $363.08 | Professional | None | $204.17 | $275.42 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $588.84 | Professional | None | $190.55 | $275.42 | $588.84 |
Lucent Health Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $363.08 Typical High $2,570.40 | Facility | None | $229.09 | $363.08 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $1,479.11 | Professional | None | $208.93 | $269.15 | $1,479.11 |
Sutter Health Plus Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | None | $691.83 | $691.83 | $831.76 |
United Setting Facility Modifier None Typical Low $123.03 Median $501.19 Typical High $3,090.30 | Facility | None | $123.03 | $501.19 | $3,090.30 |
United Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $630.96 | Professional | None | $173.78 | $251.19 | $630.96 |
13 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 Facility Modifier 52 · Reduced service Typical Low $104.71 Median $104.71 Typical High $125.89 | Facility | 52 · Reduced service | $104.71 | $104.71 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $50.12 | Facility | 53 · Discontinued | $42.66 | $42.66 | $50.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $190.55 | Facility | 54 · Surgery only | $158.49 | $158.49 | $190.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $38.02 | Facility | 55 · Aftercare only | $31.62 | $31.62 | $38.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.38 Typical High $25.12 | Facility | 56 · Pre-op care only | $20.89 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $109.65 Typical High $125.89 | Professional | 52 · Reduced service | $97.72 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $43.65 Typical High $50.12 | Professional | 53 · Discontinued | $38.90 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $165.96 Typical High $190.55 | Professional | 54 · Surgery only | $144.54 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.11 Typical High $38.02 | Professional | 55 · Aftercare only | $28.84 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $21.88 Typical High $25.12 | Professional | 56 · Pre-op care only | $19.50 | $21.88 | $25.12 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $114.82 Median $158.49 Typical High $363.08 | Professional | 62 · Two surgeons | $114.82 | $158.49 | $363.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.84 Median $38.90 Typical High $91.20 | Professional | 80 · Assistant surgeon | $28.84 | $38.90 | $91.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $25.12 Median $33.88 Typical High $79.43 | Professional | AS · PA/NP assist | $25.12 | $33.88 | $79.43 |
Where California sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 30th of 51
$302
AK $851MD $229
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.