How much rates vary
Facilitymedian $1,995 · 10th to 90th $891 to $9,550Professionalmedian $692 · 10th to 90th $550 to $5,248
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 $2,238.72 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,238.72 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $912.01 | Professional | None | $524.81 | $562.34 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,128.31 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $588.84 Typical High $2,344.23 | Professional | None | $575.44 | $588.84 | $2,344.23 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,949.84 Typical High $8,709.64 | Facility | None | $100.00 | $1,949.84 | $8,709.64 |
Blue Shield Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $891.25 | Professional | None | $467.74 | $660.69 | $891.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $933.25 | Professional | None | $588.84 | $912.01 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,630.27 Typical High $5,248.07 | Facility | None | $645.65 | $2,630.27 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $1,288.25 | Professional | None | $562.34 | $645.65 | $1,288.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $426.58 Median $851.14 Typical High $1,148.15 | Professional | None | $426.58 | $851.14 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,737.80 | Professional | None | $660.69 | $851.14 | $1,737.80 |
Lucent Health Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,623.41 | Professional | None | $5,248.07 | $5,248.07 | $5,623.41 |
Molina Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $724.44 Median $2,630.27 Typical High $6,165.95 | Facility | None | $724.44 | $2,630.27 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $1,174.90 | Professional | None | $562.34 | $630.96 | $1,174.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
United Setting Facility Modifier None Typical Low $891.25 Median $912.01 Typical High $7,244.36 | Facility | None | $891.25 | $912.01 | $7,244.36 |
United Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $1,202.26 | Professional | None | $524.81 | $707.95 | $1,202.26 |
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 $263.03 Median $281.84 Typical High $323.59 | Professional | 52 · Reduced service | $263.03 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $104.71 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $389.05 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $56.23 Typical High $64.57 | Professional | 56 · Pre-op care only | $52.48 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $363.08 | $389.05 | $446.68 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $912.01 Typical High $1,479.11 | Professional | 50 · Both sides | $741.31 | $912.01 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $389.05 Typical High $616.60 | Professional | 62 · Two surgeons | $309.03 | $389.05 | $616.60 |
Where California sits
The same service costs 3.6 times more in Wisconsin than in Montana. 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.
Physician feeFacility fee
WI $8,021MT $2,220
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.