How much rates vary
Facilitymedian $6,166 · 10th to 90th $933 to $26,303Professionalmedian $3,631 · 10th to 90th $2,512 to $12,589
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 $2,630.27 Median $8,128.31 Typical High $19,054.61 | Facility | None | $2,630.27 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $2,630.27 | Professional | None | $2,398.83 | $2,511.89 | $2,630.27 |
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 $3,548.13 Median $3,630.78 Typical High $8,317.64 | Professional | None | $3,548.13 | $3,630.78 | $8,317.64 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $3,548.13 Typical High $19,054.61 | Facility | None | $95.50 | $3,548.13 | $19,054.61 |
Blue Shield Setting Professional Modifier None Typical Low $2,511.89 Median $3,715.35 Typical High $5,128.61 | Professional | None | $2,511.89 | $3,715.35 | $5,128.61 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,548.13 Typical High $6,025.60 | Professional | None | $2,951.21 | $3,548.13 | $6,025.60 |
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 $2,951.21 Median $3,388.44 Typical High $5,128.61 | Professional | None | $2,951.21 | $3,388.44 | $5,128.61 |
Contra Costa Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,548.13 Typical High $4,365.16 | Professional | None | $3,162.28 | $3,548.13 | $4,365.16 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,691.53 Median $3,467.37 Typical High $7,244.36 | Professional | None | $2,691.53 | $3,467.37 | $7,244.36 |
Lucent Health Setting Professional Modifier None Typical Low $28,183.83 Median $28,183.83 Typical High $28,183.83 | Professional | None | $28,183.83 | $28,183.83 | $28,183.83 |
Molina Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
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 $851.14 Median $18,197.01 Typical High $32,359.37 | Facility | None | $851.14 | $18,197.01 | $32,359.37 |
Providence Setting Professional Modifier None Typical Low $2,951.21 Median $3,311.31 Typical High $5,128.61 | Professional | None | $2,951.21 | $3,311.31 | $5,128.61 |
Sutter Health Plus Setting Professional Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $10,471.29 | Professional | None | $10,471.29 | $10,471.29 | $10,471.29 |
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 $2,570.40 Median $3,162.28 Typical High $5,248.07 | Professional | None | $2,570.40 | $3,162.28 | $5,248.07 |
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 $1,202.26 Median $1,258.93 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,202.26 | $1,258.93 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $512.86 Typical High $524.81 | Professional | 53 · Discontinued | $478.63 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,905.46 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,819.70 | $1,905.46 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $380.19 Typical High $398.11 | Professional | 55 · Aftercare only | $363.08 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $251.19 Typical High $263.03 | Professional | 56 · Pre-op care only | $239.88 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,778.28 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,778.28 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $4,073.80 Median $5,128.61 Typical High $8,709.64 | Professional | 50 · Both sides | $4,073.80 | $5,128.61 | $8,709.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,737.80 Median $2,187.76 Typical High $3,630.78 | Professional | 62 · Two surgeons | $1,737.80 | $2,187.76 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $549.54 Typical High $933.25 | Professional | 80 · Assistant surgeon | $436.52 | $549.54 | $933.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $478.63 Typical High $812.83 | Professional | AS · PA/NP assist | $380.19 | $478.63 | $812.83 |
Where California sits
The same service costs 20.4 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· 37th of 51
$3,631
AK $13,183TX $646
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.