How much rates vary
Facilitymedian $3,981 · 10th to 90th $603 to $28,840Professionalmedian $331 · 10th to 90th $240 to $1,259
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 $239.88 Median $275.42 Typical High $346.74 | Professional | None | $239.88 | $275.42 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $10,964.78 Typical High $21,877.62 | Facility | None | $6,456.54 | $10,964.78 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $1,071.52 | Professional | None | $323.59 | $354.81 | $1,071.52 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $1,862.09 Typical High $6,606.93 | Facility | None | $95.50 | $1,862.09 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $776.25 | Professional | None | $234.42 | $338.84 | $776.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $1,202.26 | Professional | None | $223.87 | $275.42 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $10,000.00 | Facility | None | $660.69 | $1,412.54 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $758.58 | Professional | None | $257.04 | $302.00 | $758.58 |
Contra Costa Health Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $831.76 | Professional | None | $245.47 | $295.12 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $660.69 | Professional | None | $223.87 | $288.40 | $660.69 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Providence Setting Facility Modifier None Typical Low $512.86 Median $151,356.12 Typical High $251,188.64 | Facility | None | $512.86 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $741.31 | Professional | None | $257.04 | $295.12 | $741.31 |
Sutter Health Plus Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
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 $218.78 Median $295.12 Typical High $794.33 | Professional | None | $218.78 | $295.12 | $794.33 |
7 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 $120.23 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $120.23 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $47.86 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $181.97 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $36.31 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $23.99 | $27.54 | $27.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $36.31 Median $45.71 Typical High $109.65 | Professional | 80 · Assistant surgeon | $36.31 | $45.71 | $109.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $40.74 Typical High $95.50 | Professional | AS · PA/NP assist | $31.62 | $40.74 | $95.50 |
Where California sits
The same service costs 3.2 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· 30th of 51
$380
AK $871TX $275
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.