How much rates vary
Facilitymedian $4,898 · 10th to 90th $891 to $14,125Professionalmedian $692 · 10th to 90th $525 to $2,884
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 $7,585.78 Typical High $18,197.01 | Facility | None | $2,238.72 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $851.14 | Professional | None | $549.54 | $602.56 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,232.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $2,290.87 | Professional | None | $575.44 | $724.44 | $2,290.87 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,778.28 Typical High $10,471.29 | Facility | None | $100.00 | $1,778.28 | $10,471.29 |
Blue Shield Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $1,584.89 | Professional | None | $457.09 | $660.69 | $1,584.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $933.25 | Professional | None | $549.54 | $676.08 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,466.84 Typical High $8,912.51 | Facility | None | $758.58 | $4,466.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $1,584.89 | Professional | None | $562.34 | $645.65 | $1,584.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $741.31 | Professional | None | $489.78 | $616.60 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,380.38 | Professional | None | $537.03 | $676.08 | $1,380.38 |
Lucent Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Molina Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $4,265.80 Typical High $9,549.93 | Facility | None | $741.31 | $4,265.80 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $1,584.89 | Professional | None | $562.34 | $630.96 | $1,584.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $18,620.87 | Facility | None | $2,884.03 | $6,760.83 | $18,620.87 |
United Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $1,737.80 | Professional | None | $457.09 | $630.96 | $1,737.80 |
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 $275.42 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $275.42 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $120.23 | Professional | 53 · Discontinued | $109.65 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $416.87 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $426.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $371.54 Typical High $870.96 | Professional | 62 · Two surgeons | $295.12 | $371.54 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $95.50 Typical High $218.78 | Professional | 80 · Assistant surgeon | $74.13 | $95.50 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $83.18 Typical High $190.55 | Professional | AS · PA/NP assist | $66.07 | $83.18 | $190.55 |
Where California sits
The same service costs 8.1 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· 29th of 51
$851
OK $3,467UT $427
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.