How much rates vary
Facilitymedian $4,571 · 10th to 90th $661 to $30,200Professionalmedian $1,047 · 10th to 90th $759 to $6,310
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 $933.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $954.99 | Professional | None | $776.25 | $870.96 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $12,022.64 Typical High $23,442.29 | Facility | None | $7,244.36 | $12,022.64 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $3,388.44 | Professional | None | $870.96 | $1,096.48 | $3,388.44 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $1,862.09 Typical High $14,454.40 | Facility | None | $95.50 | $1,862.09 | $14,454.40 |
Blue Shield Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $2,344.23 | Professional | None | $691.83 | $977.24 | $2,344.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,445.44 | Professional | None | $776.25 | $933.25 | $1,445.44 |
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 $954.99 Typical High $2,344.23 | Professional | None | $812.83 | $954.99 | $2,344.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,023.29 | Professional | None | $831.76 | $933.25 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $2,137.96 | Professional | None | $758.58 | $977.24 | $2,137.96 |
Lucent Health Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $7,244.36 | Professional | None | $6,309.57 | $6,309.57 | $7,244.36 |
Molina Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $912.01 Typical High $2,398.83 | Professional | None | $812.83 | $912.01 | $2,398.83 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $2,570.40 | Professional | None | $707.95 | $954.99 | $2,570.40 |
8 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 $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $128.82 |
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 80 · Assistant surgeon Typical Low $114.82 Median $141.25 Typical High $338.84 | Professional | 80 · Assistant surgeon | $114.82 | $141.25 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $123.03 Typical High $295.12 | Professional | AS · PA/NP assist | $100.00 | $123.03 | $295.12 |
Where California sits
The same service costs 6.6 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· 22nd of 51
$1,175
AK $2,884TX $437
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.