How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,023 to $10,715Professionalmedian $1,318 · 10th to 90th $933 to $8,128
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 $1,862.09 Median $6,165.95 Typical High $15,848.93 | Facility | None | $1,862.09 | $6,165.95 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $1,122.02 | Professional | None | $977.24 | $1,023.29 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $6,606.93 Typical High $13,489.63 | Facility | None | $2,951.21 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $2,951.21 | Professional | None | $1,202.26 | $1,479.11 | $2,951.21 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,754.23 Typical High $7,943.28 | Facility | None | $100.00 | $2,754.23 | $7,943.28 |
Blue Shield Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,584.89 | Professional | None | $776.25 | $1,148.15 | $1,584.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,318.26 | Professional | None | $933.25 | $1,288.25 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $3,162.28 Typical High $6,309.57 | Facility | None | $575.44 | $3,162.28 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,174.90 | $1,778.28 |
Contra Costa Health Setting Professional Modifier None Typical Low $691.83 Median $1,148.15 Typical High $1,445.44 | Professional | None | $691.83 | $1,148.15 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $3,019.95 | Professional | None | $954.99 | $1,230.27 | $3,019.95 |
Lucent Health Setting Professional Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,912.51 | Professional | None | $8,128.31 | $8,128.31 | $8,912.51 |
Molina Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $724.44 Median $3,019.95 Typical High $6,760.83 | Facility | None | $724.44 | $3,019.95 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,148.15 | $1,737.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,623.41 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,623.41 | $17,378.01 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,819.70 | Professional | None | $870.96 | $1,096.48 | $1,819.70 |
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 $489.78 Median $512.86 Typical High $562.34 | Professional | 52 · Reduced service | $489.78 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $223.87 | Professional | 53 · Discontinued | $194.98 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $776.25 Typical High $831.76 | Professional | 54 · Surgery only | $724.44 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $154.88 Typical High $165.96 | Professional | 55 · Aftercare only | $144.54 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $724.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $676.08 | $724.44 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $173.78 Typical High $281.84 | Professional | 80 · Assistant surgeon | $134.90 | $173.78 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $151.36 Typical High $245.47 | Professional | AS · PA/NP assist | $117.49 | $151.36 | $245.47 |
Where California sits
The same service costs 6.2 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· 30th of 51
$1,445
AK $4,571UT $741
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.