How much rates vary
Facilitymedian $6,761 · 10th to 90th $646 to $46,774Professionalmedian $2,188 · 10th to 90th $1,514 to $13,183
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 $1,737.80 Median $8,511.38 Typical High $19,952.62 | Facility | None | $1,737.80 | $8,511.38 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $1,737.80 | Professional | None | $1,513.56 | $1,621.81 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $12,302.69 Typical High $27,542.29 | Facility | None | $6,918.31 | $12,302.69 | $27,542.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $4,677.35 | Professional | None | $1,995.26 | $2,344.23 | $4,677.35 |
Blue Shield Setting Facility Modifier None Typical Low $66.07 Median $4,168.69 Typical High $8,912.51 | Facility | None | $66.07 | $4,168.69 | $8,912.51 |
Blue Shield Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,819.70 | $2,511.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $2,511.89 | Professional | None | $1,737.80 | $2,187.76 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,570.40 Typical High $16,595.87 | Facility | None | $676.08 | $2,570.40 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,621.81 | $1,862.09 | $2,818.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,949.84 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $5,128.61 | Professional | None | $1,659.59 | $2,137.96 | $5,128.61 |
Lucent Health Setting Professional Modifier None Typical Low $13,182.57 Median $13,182.57 Typical High $16,595.87 | Professional | None | $13,182.57 | $13,182.57 | $16,595.87 |
Molina Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
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 $1,621.81 Median $15,135.61 Typical High $251,188.64 | Facility | None | $1,621.81 | $15,135.61 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,621.81 | $1,862.09 | $2,754.23 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,412.54 Typical High $12,022.64 | Facility | None | $524.81 | $1,412.54 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,445.44 | $1,819.70 | $2,818.38 |
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 $758.58 Median $812.83 Typical High $870.96 | Professional | 52 · Reduced service | $758.58 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $323.59 Typical High $346.74 | Professional | 53 · Discontinued | $309.03 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,230.27 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,148.15 | $1,230.27 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $245.47 Typical High $257.04 | Professional | 55 · Aftercare only | $229.09 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $162.18 Typical High $173.78 | Professional | 56 · Pre-op care only | $151.36 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,148.15 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,148.15 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $309.03 Typical High $489.78 | Professional | 80 · Assistant surgeon | $245.47 | $309.03 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $275.42 Typical High $426.58 | Professional | AS · PA/NP assist | $213.80 | $275.42 | $426.58 |
Where California sits
The same service costs 5.9 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· 28th of 51
$2,291
AK $7,762UT $1,318
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.