How much rates vary
Facilitymedian $2,884 · 10th to 90th $933 to $15,136Professionalmedian $2,291 · 10th to 90th $1,698 to $7,762
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 $1,698.24 Median $1,819.70 Typical High $1,949.84 | Professional | None | $1,698.24 | $1,819.70 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,715.19 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $5,128.61 | Professional | None | $1,949.84 | $2,290.87 | $5,128.61 |
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 $1,905.46 Median $2,754.23 Typical High $3,801.89 | Professional | None | $1,905.46 | $2,754.23 | $3,801.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $3,890.45 | Professional | None | $1,698.24 | $2,041.74 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,412.54 Typical High $2,884.03 | Facility | None | $794.33 | $1,412.54 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $3,630.78 | Professional | None | $1,862.09 | $2,290.87 | $3,630.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,862.09 | $2,041.74 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $4,168.69 | Professional | None | $1,548.82 | $1,995.26 | $4,168.69 |
Lucent Health Setting Professional Modifier None Typical Low $19,054.61 Median $19,054.61 Typical High $19,054.61 | Professional | None | $19,054.61 | $19,054.61 | $19,054.61 |
Molina Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
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 $1,548.82 Typical High $3,090.30 | Facility | None | $870.96 | $1,548.82 | $3,090.30 |
Providence Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $3,311.31 | Professional | None | $1,737.80 | $2,187.76 | $3,311.31 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $14,125.38 | Facility | None | $933.25 | $1,905.46 | $14,125.38 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,412.54 | $1,905.46 | $2,951.21 |
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 $851.14 Median $912.01 Typical High $977.24 | Professional | 52 · Reduced service | $851.14 | $912.01 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $363.08 Typical High $389.05 | Professional | 53 · Discontinued | $338.84 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,348.96 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,288.25 | $1,348.96 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $275.42 Typical High $288.40 | Professional | 55 · Aftercare only | $257.04 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $181.97 Typical High $194.98 | Professional | 56 · Pre-op care only | $169.82 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,258.93 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,258.93 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $2,884.03 Typical High $5,011.87 | Professional | 50 · Both sides | $2,290.87 | $2,884.03 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,230.27 Typical High $2,089.30 | Professional | 62 · Two surgeons | $954.99 | $1,230.27 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $309.03 Typical High $537.03 | Professional | 80 · Assistant surgeon | $245.47 | $309.03 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $269.15 Typical High $467.74 | Professional | AS · PA/NP assist | $213.80 | $269.15 | $467.74 |
Where California sits
The same service costs 18.6 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· 32nd of 51
$2,291
AK $7,413TX $398
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.