How much rates vary
Facilitymedian $5,370 · 10th to 90th $631 to $47,863Professionalmedian $1,259 · 10th to 90th $832 to $7,943
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 $776.25 Median $870.96 Typical High $1,071.52 | Professional | None | $776.25 | $870.96 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $9,332.54 Typical High $18,620.87 | Facility | None | $5,011.87 | $9,332.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $3,630.78 | Professional | None | $1,174.90 | $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 $691.83 Median $1,000.00 Typical High $2,454.71 | Professional | None | $691.83 | $1,000.00 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $10,000.00 | Facility | None | $660.69 | $1,258.93 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $2,570.40 | Professional | None | $891.25 | $1,000.00 | $2,570.40 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,174.90 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $2,884.03 | Professional | None | $954.99 | $1,230.27 | $2,884.03 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $8,912.51 | Professional | None | $7,943.28 | $7,943.28 | $8,912.51 |
Molina Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $812.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $2,630.27 | Professional | None | $891.25 | $1,000.00 | $2,630.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
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 $776.25 Median $1,047.13 Typical High $3,090.30 | Professional | None | $776.25 | $1,047.13 | $3,090.30 |
8 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 $389.05 Median $407.38 Typical High $489.78 | Professional | 52 · Reduced service | $389.05 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $194.98 | Professional | 53 · Discontinued | $154.88 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $616.60 Typical High $724.44 | Professional | 54 · Surgery only | $575.44 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $114.82 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $575.44 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $537.03 | $575.44 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $165.96 Typical High $398.11 | Professional | 80 · Assistant surgeon | $128.82 | $165.96 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $144.54 Typical High $346.74 | Professional | AS · PA/NP assist | $112.20 | $144.54 | $346.74 |
Where California sits
The same service costs 6.8 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· 28th of 51
$1,318
AK $4,074TX $603
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.