How much rates vary
Facilitymedian $5,623 · 10th to 90th $794 to $17,783Professionalmedian $617 · 10th to 90th $245 to $4,365
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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $588.84 | Professional | None | $512.86 | $549.54 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $13,803.84 Typical High $25,118.86 | Facility | None | $6,918.31 | $13,803.84 | $25,118.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $1,318.26 | Professional | None | $758.58 | $776.25 | $1,318.26 |
Blue Shield Setting Facility Modifier None Typical Low $66.07 Median $3,162.28 Typical High $6,606.93 | Facility | None | $66.07 | $3,162.28 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $407.38 | Professional | None | $204.17 | $302.00 | $407.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $489.78 | Professional | None | $309.03 | $380.19 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,290.87 Typical High $6,760.83 | Facility | None | $691.83 | $2,290.87 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $933.25 | Professional | None | $537.03 | $616.60 | $933.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $371.54 | Professional | None | $257.04 | $323.59 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $831.76 | Professional | None | $309.03 | $363.08 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $5,011.87 | Professional | None | $4,365.16 | $4,365.16 | $5,011.87 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $3,548.13 Typical High $14,125.38 | Facility | None | $630.96 | $3,548.13 | $14,125.38 |
Providence Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $933.25 | Professional | None | $537.03 | $602.56 | $933.25 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $5,248.07 Typical High $17,378.01 | Facility | None | $1,659.59 | $5,248.07 | $17,378.01 |
United Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $630.96 | Professional | None | $223.87 | $302.00 | $630.96 |
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 $257.04 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $257.04 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $109.65 Typical High $117.49 | Professional | 53 · Discontinued | $102.33 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $407.38 Typical High $446.68 | Professional | 54 · Surgery only | $380.19 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $89.13 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $58.88 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $58.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $1,148.15 Typical High $1,479.11 | Professional | 50 · Both sides | $389.05 | $1,148.15 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $165.96 Median $478.63 Typical High $616.60 | Professional | 62 · Two surgeons | $165.96 | $478.63 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $44.67 Median $123.03 Typical High $158.49 | Professional | 80 · Assistant surgeon | $44.67 | $123.03 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.90 Median $107.15 Typical High $138.04 | Professional | AS · PA/NP assist | $38.90 | $107.15 | $138.04 |
Where California sits
The same service costs 10.0 times more in Alaska than in Kentucky. 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
$676
AK $2,455KY $245
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.