How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $61,660Professionalmedian $1,288 · 10th to 90th $871 to $9,120
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 $851.14 Median $954.99 Typical High $1,862.09 | Professional | None | $851.14 | $954.99 | $1,862.09 |
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 $1,288.25 Median $1,412.54 Typical High $4,168.69 | Professional | None | $1,288.25 | $1,412.54 | $4,168.69 |
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 $676.08 Median $977.24 Typical High $2,454.71 | Professional | None | $676.08 | $977.24 | $2,454.71 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,513.56 | $1,698.24 |
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 $870.96 Median $1,096.48 Typical High $3,019.95 | Professional | None | $870.96 | $1,096.48 | $3,019.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $1,621.81 | Professional | None | $891.25 | $1,348.96 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $3,630.78 | Professional | None | $1,202.26 | $1,513.56 | $3,630.78 |
Lucent Health Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $10,964.78 | Professional | None | $9,120.11 | $9,120.11 | $10,964.78 |
Molina Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $870.96 Median $1,096.48 Typical High $3,162.28 | Professional | None | $870.96 | $1,096.48 | $3,162.28 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
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 $851.14 Median $1,230.27 Typical High $3,715.35 | Professional | None | $851.14 | $1,230.27 | $3,715.35 |
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 $407.38 Median $436.52 Typical High $524.81 | Professional | 52 · Reduced service | $407.38 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $173.78 Typical High $213.80 | Professional | 53 · Discontinued | $165.96 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $645.65 Typical High $794.33 | Professional | 54 · Surgery only | $616.60 | $645.65 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $128.82 Typical High $158.49 | Professional | 55 · Aftercare only | $123.03 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $87.10 Typical High $107.15 | Professional | 56 · Pre-op care only | $83.18 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $741.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $758.58 Typical High $1,905.46 | Professional | 62 · Two surgeons | $602.56 | $758.58 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $194.98 Typical High $478.63 | Professional | 80 · Assistant surgeon | $154.88 | $194.98 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $169.82 Typical High $416.87 | Professional | AS · PA/NP assist | $134.90 | $169.82 | $416.87 |
Where California sits
The same service costs 5.6 times more in Alaska 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· 32nd of 51
$1,413
AK $5,012UT $891
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.