How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,698 to $15,488Professionalmedian $3,020 · 10th to 90th $2,239 to $19,055
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 $2,570.40 Median $7,585.78 Typical High $18,197.01 | Facility | None | $2,570.40 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,398.83 Typical High $2,570.40 | Professional | None | $2,290.87 | $2,398.83 | $2,570.40 |
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 $2,818.38 Median $3,019.95 Typical High $6,760.83 | Professional | None | $2,818.38 | $3,019.95 | $6,760.83 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $3,162.28 Typical High $12,022.64 | Facility | None | $95.50 | $3,162.28 | $12,022.64 |
Blue Shield Setting Professional Modifier None Typical Low $1,995.26 Median $2,884.03 Typical High $4,073.80 | Professional | None | $1,995.26 | $2,884.03 | $4,073.80 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,884.03 Typical High $3,801.89 | Professional | None | $2,398.83 | $2,884.03 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $7,244.36 Typical High $13,489.63 | Facility | None | $794.33 | $7,244.36 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,754.23 Typical High $4,168.69 | Professional | None | $2,454.71 | $2,754.23 | $4,168.69 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,630.27 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,630.27 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,818.38 Typical High $5,888.44 | Professional | None | $2,187.76 | $2,818.38 | $5,888.44 |
Lucent Health Setting Professional Modifier None Typical Low $19,054.61 Median $19,054.61 Typical High $20,417.38 | Professional | None | $19,054.61 | $19,054.61 | $20,417.38 |
Molina Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
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 $7,079.46 Typical High $13,182.57 | Facility | None | $870.96 | $7,079.46 | $13,182.57 |
Providence Setting Professional Modifier None Typical Low $2,454.71 Median $2,754.23 Typical High $4,073.80 | Professional | None | $2,454.71 | $2,754.23 | $4,073.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | None | $8,511.38 | $8,511.38 | $8,511.38 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $18,620.87 | Facility | None | $2,884.03 | $6,760.83 | $18,620.87 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $4,265.80 | Professional | None | $2,089.30 | $2,630.27 | $4,265.80 |
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 $1,148.15 Median $1,202.26 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,148.15 | $1,202.26 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $478.63 Typical High $512.86 | Professional | 53 · Discontinued | $457.09 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,819.70 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,698.24 | $1,819.70 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $363.08 Typical High $380.19 | Professional | 55 · Aftercare only | $338.84 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $239.88 Typical High $257.04 | Professional | 56 · Pre-op care only | $229.09 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,698.24 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,698.24 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,659.59 Typical High $2,884.03 | Professional | 62 · Two surgeons | $1,380.38 | $1,659.59 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $426.58 Typical High $741.31 | Professional | 80 · Assistant surgeon | $346.74 | $426.58 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $371.54 Typical High $645.65 | Professional | AS · PA/NP assist | $309.03 | $371.54 | $645.65 |
Where California sits
The same service costs 8.7 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· 34th of 51
$3,020
AK $10,715TX $1,230
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.