How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,259 to $32,359Professionalmedian $2,239 · 10th to 90th $1,738 to $9,550
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 $1,949.84 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,949.84 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,862.09 Typical High $1,949.84 | Professional | None | $1,737.80 | $1,862.09 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $12,302.69 Typical High $25,118.86 | Facility | None | $6,918.31 | $12,302.69 | $25,118.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $7,943.28 | Professional | None | $2,187.76 | $2,398.83 | $7,943.28 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $2,290.87 Typical High $9,332.54 | Facility | None | $95.50 | $2,290.87 | $9,332.54 |
Blue Shield Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $5,011.87 | Professional | None | $1,412.54 | $2,041.74 | $5,011.87 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,778.28 | $2,187.76 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,479.11 Typical High $10,000.00 | Facility | None | $660.69 | $1,479.11 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $5,495.41 | Professional | None | $1,905.46 | $2,187.76 | $5,495.41 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $2,570.40 | Professional | None | $1,737.80 | $2,187.76 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $4,786.30 | Professional | None | $1,737.80 | $2,187.76 | $4,786.30 |
Lucent Health Setting Professional Modifier None Typical Low $26,915.35 Median $26,915.35 Typical High $26,915.35 | Professional | None | $26,915.35 | $26,915.35 | $26,915.35 |
Molina Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $151,356.12 Typical High $251,188.64 | Facility | None | $851.14 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $5,495.41 | Professional | None | $1,905.46 | $2,187.76 | $5,495.41 |
Sutter Health Plus Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,606.93 | $6,606.93 | $6,606.93 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,495.41 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,495.41 | $17,378.01 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,137.96 Typical High $6,165.95 | Professional | None | $1,584.89 | $2,137.96 | $6,165.95 |
10 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 $870.96 Median $933.25 Typical High $977.24 | Professional | 52 · Reduced service | $870.96 | $933.25 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $371.54 Typical High $389.05 | Professional | 53 · Discontinued | $346.74 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,380.38 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,318.26 | $1,380.38 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $275.42 Typical High $288.40 | Professional | 55 · Aftercare only | $263.03 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $186.21 Typical High $194.98 | Professional | 56 · Pre-op care only | $173.78 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,288.25 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,288.25 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,630.27 Typical High $7,244.36 | Professional | 50 · Both sides | $2,041.74 | $2,630.27 | $7,244.36 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,122.02 Typical High $3,019.95 | Professional | 62 · Two surgeons | $870.96 | $1,122.02 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $281.84 Typical High $758.58 | Professional | 80 · Assistant surgeon | $218.78 | $281.84 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $245.47 Typical High $676.08 | Professional | AS · PA/NP assist | $190.55 | $245.47 | $676.08 |
Where California sits
The same service costs 8.5 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
$2,455
AK $8,128TX $955
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.