How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,349 to $13,804Professionalmedian $1,514 · 10th to 90th $1,148 to $4,571
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 $2,238.72 Median $7,585.78 Typical High $18,197.01 | Facility | None | $2,238.72 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,949.84 | Professional | None | $1,202.26 | $1,380.38 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $11,481.54 Typical High $21,379.62 | Facility | None | $6,025.60 | $11,481.54 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $3,311.31 | Professional | None | $1,445.44 | $1,584.89 | $3,311.31 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $2,691.53 Typical High $5,888.44 | Facility | None | $95.50 | $2,691.53 | $5,888.44 |
Blue Shield Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $1,949.84 | Professional | None | $954.99 | $1,412.54 | $1,949.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,584.89 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,466.84 Typical High $7,413.10 | Facility | None | $794.33 | $4,466.84 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,258.93 | $1,412.54 | $2,238.72 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,412.54 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $3,801.89 | Professional | None | $1,174.90 | $1,479.11 | $3,801.89 |
Lucent Health 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 |
Molina Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $4,265.80 Typical High $7,079.46 | Facility | None | $870.96 | $4,265.80 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,258.93 | $1,380.38 | $2,137.96 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
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 $1,047.13 Median $1,318.26 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,318.26 | $2,238.72 |
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 $602.56 Median $630.96 Typical High $676.08 | Professional | 52 · Reduced service | $602.56 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $251.19 Typical High $269.15 | Professional | 53 · Discontinued | $239.88 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $954.99 Typical High $1,023.29 | Professional | 54 · Surgery only | $891.25 | $954.99 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $204.17 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $125.89 Typical High $134.90 | Professional | 56 · Pre-op care only | $120.23 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $891.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $831.76 | $891.25 | $954.99 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $891.25 Typical High $1,479.11 | Professional | 62 · Two surgeons | $707.95 | $891.25 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $223.87 Typical High $371.54 | Professional | 80 · Assistant surgeon | $181.97 | $223.87 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $194.98 Typical High $331.13 | Professional | AS · PA/NP assist | $158.49 | $194.98 | $331.13 |
Where California sits
The same service costs 15.1 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· 35th of 51
$1,549
AK $5,370TX $355
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.