How much rates vary
Facilitymedian $6,166 · 10th to 90th $933 to $26,303Professionalmedian $4,786 · 10th to 90th $3,388 to $15,488
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 $3,801.89 Median $8,128.31 Typical High $19,054.61 | Facility | None | $3,801.89 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $3,630.78 Median $3,801.89 Typical High $4,073.80 | Professional | None | $3,630.78 | $3,801.89 | $4,073.80 |
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 $4,265.80 Median $4,786.30 Typical High $10,471.29 | Professional | None | $4,265.80 | $4,786.30 | $10,471.29 |
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 $3,090.30 Median $4,570.88 Typical High $6,309.57 | Professional | None | $3,090.30 | $4,570.88 | $6,309.57 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3,467.37 Median $4,265.80 Typical High $6,606.93 | Professional | None | $3,467.37 | $4,265.80 | $6,606.93 |
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 $3,715.35 Median $4,265.80 Typical High $6,456.54 | Professional | None | $3,715.35 | $4,265.80 | $6,456.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $5,128.61 | Professional | None | $3,548.13 | $4,168.69 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,235.94 Median $4,168.69 Typical High $8,709.64 | Professional | None | $3,235.94 | $4,168.69 | $8,709.64 |
Lucent Health Setting Professional Modifier None Typical Low $31,622.78 Median $31,622.78 Typical High $31,622.78 | Professional | None | $31,622.78 | $31,622.78 | $31,622.78 |
Molina Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
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 $3,715.35 Median $4,265.80 Typical High $6,309.57 | Professional | None | $3,715.35 | $4,265.80 | $6,309.57 |
Sutter Health Plus Setting Professional Modifier None Typical Low $12,882.50 Median $12,882.50 Typical High $12,882.50 | Professional | None | $12,882.50 | $12,882.50 | $12,882.50 |
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 $3,090.30 Median $3,981.07 Typical High $6,309.57 | Professional | None | $3,090.30 | $3,981.07 | $6,309.57 |
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 $1,778.28 Median $1,905.46 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,778.28 | $1,905.46 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $758.58 Typical High $812.83 | Professional | 53 · Discontinued | $724.44 | $758.58 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,884.03 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,691.53 | $2,884.03 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $575.44 Typical High $602.56 | Professional | 55 · Aftercare only | $537.03 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $380.19 Typical High $407.38 | Professional | 56 · Pre-op care only | $363.08 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,691.53 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,691.53 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $5,011.87 Median $6,165.95 Typical High $10,471.29 | Professional | 50 · Both sides | $5,011.87 | $6,165.95 | $10,471.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,089.30 Median $2,630.27 Typical High $4,466.84 | Professional | 62 · Two surgeons | $2,089.30 | $2,630.27 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $660.69 Typical High $1,122.02 | Professional | 80 · Assistant surgeon | $524.81 | $660.69 | $1,122.02 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $467.74 Median $575.44 Typical High $977.24 | Professional | AS · PA/NP assist | $467.74 | $575.44 | $977.24 |
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· 31st of 51
$4,786
AK $15,849TX $776
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.