How much rates vary
Facilitymedian $4,571 · 10th to 90th $776 to $14,791Professionalmedian $589 · 10th to 90th $269 to $4,074
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 $489.78 Median $512.86 Typical High $602.56 | Professional | None | $489.78 | $512.86 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,456.54 Typical High $14,125.38 | Facility | None | $2,884.03 | $6,456.54 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $1,288.25 | Professional | None | $707.95 | $741.31 | $1,288.25 |
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 $234.42 Median $338.84 Typical High $457.09 | Professional | None | $234.42 | $338.84 | $457.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $467.74 | Professional | None | $316.23 | $426.58 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,290.87 Typical High $15,135.61 | Facility | None | $691.83 | $2,290.87 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $891.25 | Professional | None | $512.86 | $588.84 | $891.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $354.81 | Professional | None | $245.47 | $309.03 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $831.76 | Professional | None | $338.84 | $398.11 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,786.30 | Professional | None | $4,073.80 | $4,073.80 | $4,786.30 |
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 $616.60 Median $3,548.13 Typical High $15,135.61 | Facility | None | $616.60 | $3,548.13 | $15,135.61 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $891.25 | Professional | None | $512.86 | $575.44 | $891.25 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $5,011.87 Typical High $17,378.01 | Facility | None | $1,659.59 | $5,011.87 | $17,378.01 |
United Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $602.56 | Professional | None | $251.19 | $323.59 | $602.56 |
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 $245.47 Median $257.04 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $426.58 | Professional | 54 · Surgery only | $363.08 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $56.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $1,047.13 Typical High $1,412.54 | Professional | 50 · Both sides | $389.05 | $1,047.13 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $162.18 Median $436.52 Typical High $588.84 | Professional | 62 · Two surgeons | $162.18 | $436.52 | $588.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $44.67 Median $109.65 Typical High $147.91 | Professional | 80 · Assistant surgeon | $44.67 | $109.65 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.90 Median $97.72 Typical High $131.83 | Professional | AS · PA/NP assist | $38.90 | $97.72 | $131.83 |
Where California sits
The same service costs 10.5 times more in Alaska than in Hawaii. 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· 29th of 51
$603
AK $2,344HI $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.