How much rates vary
Facilitymedian $2,344 · 10th to 90th $933 to $13,490Professionalmedian $2,188 · 10th to 90th $1,549 to $7,413
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 $1,862.09 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,862.09 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $1,862.09 | Professional | None | $1,659.59 | $1,737.80 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $11,481.54 Typical High $21,379.62 | Facility | None | $5,011.87 | $11,481.54 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $4,897.79 | Professional | None | $1,905.46 | $2,187.76 | $4,897.79 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,630.78 Typical High $18,620.87 | Facility | None | $100.00 | $3,630.78 | $18,620.87 |
Blue Shield Setting Professional Modifier None Typical Low $1,479.11 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,479.11 | $2,187.76 | $3,090.30 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $3,630.78 | Professional | None | $1,659.59 | $1,995.26 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $2,884.03 | Facility | None | $691.83 | $1,380.38 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $3,548.13 | Professional | None | $1,778.28 | $2,187.76 | $3,548.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,819.70 | $1,995.26 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $3,981.07 | Professional | None | $1,513.56 | $1,949.84 | $3,981.07 |
Lucent Health Setting Professional Modifier None Typical Low $17,378.01 Median $17,378.01 Typical High $17,378.01 | Professional | None | $17,378.01 | $17,378.01 | $17,378.01 |
Molina Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
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 $776.25 Median $1,659.59 Typical High $5,623.41 | Facility | None | $776.25 | $1,659.59 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,698.24 | $2,137.96 | $3,235.94 |
Sutter Health Plus 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 |
United Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $7,585.78 | Facility | None | $933.25 | $933.25 | $7,585.78 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,862.09 | $2,884.03 |
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 $812.83 Median $870.96 Typical High $933.25 | Professional | 52 · Reduced service | $812.83 | $870.96 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $346.74 Typical High $371.54 | Professional | 53 · Discontinued | $331.13 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,318.26 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,230.27 | $1,318.26 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $263.03 Typical High $281.84 | Professional | 55 · Aftercare only | $245.47 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $173.78 Typical High $186.21 | Professional | 56 · Pre-op care only | $165.96 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,230.27 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,230.27 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,174.90 Typical High $2,041.74 | Professional | 62 · Two surgeons | $933.25 | $1,174.90 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $302.00 Typical High $524.81 | Professional | 80 · Assistant surgeon | $234.42 | $302.00 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $263.03 Typical High $457.09 | Professional | AS · PA/NP assist | $208.93 | $263.03 | $457.09 |
Where California sits
The same service costs 21.4 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· 33rd of 51
$2,188
AK $7,244TX $339
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.