How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $61,660Professionalmedian $1,259 · 10th to 90th $832 to $4,677
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 $954.99 Median $8,128.31 Typical High $19,054.61 | Facility | None | $954.99 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $2,630.27 | Professional | None | $831.76 | $891.25 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $12,589.25 Typical High $27,542.29 | Facility | None | $7,079.46 | $12,589.25 | $27,542.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $3,630.78 | Professional | None | $851.14 | $1,318.26 | $3,630.78 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,606.93 | Facility | None | $67.61 | $3,090.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $2,344.23 | Professional | None | $660.69 | $933.25 | $2,344.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $1,318.26 | Professional | None | $870.96 | $1,258.93 | $1,318.26 |
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 $912.01 Median $1,023.29 Typical High $2,570.40 | Professional | None | $912.01 | $1,023.29 | $2,570.40 |
Contra Costa Health Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,348.96 | Professional | None | $691.83 | $1,122.02 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $3,019.95 | Professional | None | $1,000.00 | $1,258.93 | $3,019.95 |
Lucent Health Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $9,549.93 | Professional | None | $9,549.93 | $9,549.93 | $9,549.93 |
Molina Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $151,356.12 Typical High $251,188.64 | Facility | None | $851.14 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $2,691.53 | Professional | None | $912.01 | $1,023.29 | $2,691.53 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
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 $794.33 Median $1,047.13 Typical High $3,162.28 | Professional | None | $794.33 | $1,047.13 | $3,162.28 |
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 $416.87 Median $446.68 Typical High $489.78 | Professional | 52 · Reduced service | $416.87 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $177.83 Typical High $199.53 | Professional | 53 · Discontinued | $165.96 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $616.60 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $134.90 Typical High $147.91 | Professional | 55 · Aftercare only | $123.03 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $89.13 Typical High $100.00 | Professional | 56 · Pre-op care only | $83.18 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $575.44 | $616.60 | $691.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $645.65 Typical High $1,584.89 | Professional | 62 · Two surgeons | $524.81 | $645.65 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $162.18 Typical High $407.38 | Professional | 80 · Assistant surgeon | $131.83 | $162.18 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $144.54 Typical High $354.81 | Professional | AS · PA/NP assist | $114.82 | $144.54 | $354.81 |
Where California sits
The same service costs 18.6 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· 26th of 51
$1,288
AK $4,169TX $224
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.