How much rates vary
Facilitymedian $5,888 · 10th to 90th $933 to $25,119Professionalmedian $2,818 · 10th to 90th $2,042 to $10,471
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 $8,128.31 Typical High $19,054.61 | Facility | None | $2,238.72 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,137.96 Typical High $2,238.72 | Professional | None | $2,041.74 | $2,137.96 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $14,125.38 Typical High $25,118.86 | Facility | None | $7,244.36 | $14,125.38 | $25,118.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $2,818.38 Typical High $7,079.46 | Professional | None | $2,754.23 | $2,818.38 | $7,079.46 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $3,548.13 Typical High $12,022.64 | Facility | None | $95.50 | $3,548.13 | $12,022.64 |
Blue Shield Setting Professional Modifier None Typical Low $1,862.09 Median $2,754.23 Typical High $3,801.89 | Professional | None | $1,862.09 | $2,754.23 | $3,801.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $4,365.16 | Professional | None | $2,511.89 | $3,019.95 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $19,054.61 Typical High $34,673.69 | Facility | None | $794.33 | $19,054.61 | $34,673.69 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,754.23 Typical High $4,365.16 | Professional | None | $2,398.83 | $2,754.23 | $4,365.16 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,884.03 Typical High $3,715.35 | Professional | None | $2,290.87 | $2,884.03 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $2,951.21 Typical High $6,165.95 | Professional | None | $2,290.87 | $2,951.21 | $6,165.95 |
Lucent Health Setting Professional Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Professional | None | $21,379.62 | $21,379.62 | $21,379.62 |
Molina Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
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 $870.96 Median $18,197.01 Typical High $32,359.37 | Facility | None | $870.96 | $18,197.01 | $32,359.37 |
Providence Setting Professional Modifier None Typical Low $2,398.83 Median $2,754.23 Typical High $4,265.80 | Professional | None | $2,398.83 | $2,754.23 | $4,265.80 |
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 $933.25 Median $3,467.37 Typical High $18,620.87 | Facility | None | $933.25 | $3,467.37 | $18,620.87 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $4,466.84 | Professional | None | $2,089.30 | $2,630.27 | $4,466.84 |
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 $1,023.29 Median $1,071.52 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,023.29 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $426.58 Typical High $446.68 | Professional | 53 · Discontinued | $407.38 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,584.89 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,513.56 | $1,584.89 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $316.23 Typical High $338.84 | Professional | 55 · Aftercare only | $302.00 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $213.80 Typical High $223.87 | Professional | 56 · Pre-op care only | $204.17 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,479.11 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,479.11 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,467.37 Median $4,265.80 Typical High $7,079.46 | Professional | 50 · Both sides | $3,467.37 | $4,265.80 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $1,819.70 Typical High $2,951.21 | Professional | 62 · Two surgeons | $1,445.44 | $1,819.70 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $457.09 Typical High $741.31 | Professional | 80 · Assistant surgeon | $371.54 | $457.09 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $398.11 Typical High $660.69 | Professional | AS · PA/NP assist | $323.59 | $398.11 | $660.69 |
Where California sits
The same service costs 20.0 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· 40th of 51
$2,818
AK $11,220TX $562
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.