How much rates vary
Facilitymedian $7,586 · 10th to 90th $631 to $61,660Professionalmedian $3,631 · 10th to 90th $2,399 to $19,953
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 $2,630.27 Median $8,128.31 Typical High $19,054.61 | Facility | None | $2,630.27 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,511.89 Typical High $3,162.28 | Professional | None | $2,344.23 | $2,511.89 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $13,803.84 Typical High $28,840.32 | Facility | None | $7,943.28 | $13,803.84 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,548.13 Median $3,801.89 Typical High $10,715.19 | Professional | None | $3,548.13 | $3,801.89 | $10,715.19 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $6,760.83 Typical High $14,125.38 | Facility | None | $67.61 | $6,760.83 | $14,125.38 |
Blue Shield Setting Professional Modifier None Typical Low $2,137.96 Median $3,090.30 Typical High $7,244.36 | Professional | None | $2,137.96 | $3,090.30 | $7,244.36 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,162.28 Typical High $4,168.69 | Professional | None | $2,630.27 | $3,162.28 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,445.44 Typical High $10,000.00 | Facility | None | $660.69 | $1,445.44 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $7,585.78 | Professional | None | $2,630.27 | $3,019.95 | $7,585.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $3,467.37 | Professional | None | $2,187.76 | $2,884.03 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $7,585.78 | Professional | None | $2,570.40 | $3,311.31 | $7,585.78 |
Lucent Health Setting Professional Modifier None Typical Low $19,952.62 Median $19,952.62 Typical High $24,547.09 | Professional | None | $19,952.62 | $19,952.62 | $24,547.09 |
Molina Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
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 $2,630.27 Median $2,884.03 Typical High $7,585.78 | Professional | None | $2,630.27 | $2,884.03 | $7,585.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
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 $2,290.87 Median $3,019.95 Typical High $8,709.64 | Professional | None | $2,290.87 | $3,019.95 | $8,709.64 |
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 $1,174.90 Median $1,258.93 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,174.90 | $1,258.93 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $501.19 Typical High $562.34 | Professional | 53 · Discontinued | $467.74 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,905.46 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,778.28 | $1,905.46 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $380.19 Typical High $426.58 | Professional | 55 · Aftercare only | $354.81 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $251.19 Typical High $281.84 | Professional | 56 · Pre-op care only | $234.42 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,778.28 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,778.28 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,479.11 Median $1,862.09 Typical High $4,570.88 | Professional | 62 · Two surgeons | $1,479.11 | $1,862.09 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $467.74 Typical High $1,148.15 | Professional | 80 · Assistant surgeon | $371.54 | $467.74 | $1,148.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $331.13 Median $407.38 Typical High $1,000.00 | Professional | AS · PA/NP assist | $331.13 | $407.38 | $1,000.00 |
Where California sits
The same service costs 13.1 times more in Maine 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.
Physician feeFacility fee
ME $36,340TX $2,769
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.