How much rates vary
Facilitymedian $2,344 · 10th to 90th $708 to $10,715Professionalmedian $2,630 · 10th to 90th $2,042 to $19,498
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 $2,398.83 Median $7,585.78 Typical High $18,197.01 | Facility | None | $2,398.83 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,290.87 Typical High $2,630.27 | Professional | None | $2,137.96 | $2,290.87 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $10,000.00 Typical High $18,620.87 | Facility | None | $4,570.88 | $10,000.00 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $2,187.76 Typical High $10,232.93 | Professional | None | $2,041.74 | $2,187.76 | $10,232.93 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,737.80 Typical High $6,606.93 | Facility | None | $100.00 | $1,737.80 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $1,778.28 Median $2,570.40 Typical High $3,630.78 | Professional | None | $1,778.28 | $2,570.40 | $3,630.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $2,951.21 | Professional | None | $1,778.28 | $2,454.71 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,778.28 Typical High $3,715.35 | Facility | None | $758.58 | $1,778.28 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $2,630.27 Typical High $4,466.84 | Professional | None | $2,344.23 | $2,630.27 | $4,466.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,258.93 Median $2,691.53 Typical High $3,090.30 | Professional | None | $1,258.93 | $2,691.53 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,238.72 Median $2,754.23 Typical High $7,079.46 | Professional | None | $2,238.72 | $2,754.23 | $7,079.46 |
Lucent Health Setting Professional Modifier None Typical Low $19,498.45 Median $19,498.45 Typical High $20,417.38 | Professional | None | $19,498.45 | $19,498.45 | $20,417.38 |
Molina Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,089.30 Typical High $5,128.61 | Facility | None | $812.83 | $2,089.30 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $2,290.87 Median $2,630.27 Typical High $4,365.16 | Professional | None | $2,290.87 | $2,630.27 | $4,365.16 |
Sutter Health Plus Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,630.27 Typical High $5,128.61 | Professional | None | $2,041.74 | $2,630.27 | $5,128.61 |
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 $1,023.29 Median $1,148.15 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,023.29 | $1,148.15 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $457.09 Typical High $478.63 | Professional | 53 · Discontinued | $407.38 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,698.24 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,548.82 | $1,698.24 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $338.84 Typical High $363.08 | Professional | 55 · Aftercare only | $309.03 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $229.09 Typical High $239.88 | Professional | 56 · Pre-op care only | $204.17 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,584.89 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,584.89 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,995.26 Typical High $2,818.38 | Professional | 62 · Two surgeons | $1,412.54 | $1,995.26 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $501.19 Typical High $724.44 | Professional | 80 · Assistant surgeon | $371.54 | $501.19 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $436.52 Typical High $630.96 | Professional | AS · PA/NP assist | $316.23 | $436.52 | $630.96 |
Where California sits
The same service costs 15.8 times more in Alaska than in Texas. 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· 34th of 51
$2,630
AK $8,128TX $513
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.