How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,072 to $14,791Professionalmedian $1,413 · 10th to 90th $1,023 to $4,677
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 $1,905.46 Median $6,165.95 Typical High $15,848.93 | Facility | None | $1,905.46 | $6,165.95 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,148.15 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $11,481.54 Typical High $20,417.38 | Facility | None | $5,888.44 | $11,481.54 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $2,951.21 | Professional | None | $1,096.48 | $1,479.11 | $2,951.21 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,949.84 Typical High $14,125.38 | Facility | None | $100.00 | $1,949.84 | $14,125.38 |
Blue Shield Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $1,862.09 | Professional | None | $933.25 | $1,348.96 | $1,862.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,288.25 | Professional | None | $851.14 | $1,202.26 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,466.84 Typical High $8,912.51 | Facility | None | $645.65 | $4,466.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,258.93 | $1,949.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $562.34 Median $1,148.15 Typical High $1,445.44 | Professional | None | $562.34 | $1,148.15 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $2,691.53 | Professional | None | $977.24 | $1,230.27 | $2,691.53 |
Lucent Health Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Professional | None | $10,000.00 | $10,000.00 | $10,000.00 |
Molina Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $758.58 Median $4,265.80 Typical High $9,120.11 | Facility | None | $758.58 | $4,265.80 | $9,120.11 |
Providence Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,258.93 | $1,905.46 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,754.40 | $17,378.01 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,949.84 | Professional | None | $933.25 | $1,202.26 | $1,949.84 |
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 $549.54 Median $575.44 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $245.47 | Professional | 53 · Discontinued | $218.78 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $933.25 | Professional | 54 · Surgery only | $812.83 | $870.96 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $173.78 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $870.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $758.58 Typical High $1,288.25 | Professional | 62 · Two surgeons | $602.56 | $758.58 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $190.55 Typical High $331.13 | Professional | 80 · Assistant surgeon | $154.88 | $190.55 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $169.82 Typical High $288.40 | Professional | AS · PA/NP assist | $134.90 | $169.82 | $288.40 |
Where California sits
The same service costs 16.6 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
$1,445
AK $4,677TX $282
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.