How much rates vary
Facilitymedian $2,291 · 10th to 90th $151 to $7,079Professionalmedian $457 · 10th to 90th $302 to $2,570
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 $316.23 Median $331.13 Typical High $436.52 | Professional | None | $316.23 | $331.13 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $10,000.00 | Facility | None | $2,137.96 | $4,786.30 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $1,047.13 | Professional | None | $380.19 | $501.19 | $1,047.13 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $2,630.27 Typical High $5,888.44 | Facility | None | $95.50 | $2,630.27 | $5,888.44 |
Blue Shield Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $562.34 | Professional | None | $281.84 | $407.38 | $562.34 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $660.69 | Professional | None | $302.00 | $371.54 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $575.44 Typical High $2,691.53 | Facility | None | $338.84 | $575.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $575.44 | Professional | None | $354.81 | $389.05 | $575.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $446.68 | Professional | None | $331.13 | $363.08 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $891.25 | Professional | None | $302.00 | $371.54 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,691.53 | Professional | None | $2,570.40 | $2,570.40 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
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 $338.84 Median $549.54 Typical High $2,511.89 | Facility | None | $338.84 | $549.54 | $2,511.89 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $575.44 | Professional | None | $354.81 | $389.05 | $575.44 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
United Setting Facility Modifier None Typical Low $123.03 Median $501.19 Typical High $3,090.30 | Facility | None | $123.03 | $501.19 | $3,090.30 |
United Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $575.44 | Professional | None | $288.40 | $371.54 | $575.44 |
7 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 $158.49 Median $165.96 Typical High $177.83 | Professional | 52 · Reduced service | $158.49 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $66.07 Typical High $72.44 | Professional | 53 · Discontinued | $63.10 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $245.47 Typical High $269.15 | Professional | 54 · Surgery only | $234.42 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $50.12 Typical High $53.70 | Professional | 55 · Aftercare only | $46.77 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.11 Typical High $35.48 | Professional | 56 · Pre-op care only | $31.62 | $33.11 | $35.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $44.67 Median $57.54 Typical High $102.33 | Professional | 80 · Assistant surgeon | $44.67 | $57.54 | $102.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.90 Median $50.12 Typical High $87.10 | Professional | AS · PA/NP assist | $38.90 | $50.12 | $87.10 |
Where California sits
The same service costs 4.9 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· 23rd of 51
$501
AK $1,445UT $295
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.