How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,259 to $14,791Professionalmedian $1,862 · 10th to 90th $1,349 to $6,026
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 $1,445.44 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,445.44 | $1,584.89 | $2,290.87 |
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 $1,698.24 Median $1,949.84 Typical High $3,981.07 | Professional | None | $1,698.24 | $1,949.84 | $3,981.07 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $4,466.84 Typical High $8,912.51 | Facility | None | $69.18 | $4,466.84 | $8,912.51 |
Blue Shield Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,621.81 | $2,238.72 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,862.09 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $5,623.41 Typical High $9,549.93 | Facility | None | $794.33 | $5,623.41 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,737.80 | $2,691.53 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,659.59 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $4,466.84 | Professional | None | $1,380.38 | $1,778.28 | $4,466.84 |
Lucent Health Setting Professional Modifier None Typical Low $14,791.08 Median $14,791.08 Typical High $14,791.08 | Professional | None | $14,791.08 | $14,791.08 | $14,791.08 |
Molina Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
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 $5,248.07 Typical High $8,912.51 | Facility | None | $870.96 | $5,248.07 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,513.56 | $1,698.24 | $2,570.40 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
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 $1,258.93 Median $1,584.89 Typical High $2,754.23 | Professional | None | $1,258.93 | $1,584.89 | $2,754.23 |
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 $741.31 Median $794.33 Typical High $831.76 | Professional | 52 · Reduced service | $741.31 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $316.23 Typical High $338.84 | Professional | 53 · Discontinued | $295.12 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,174.90 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,122.02 | $1,174.90 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $234.42 Typical High $251.19 | Professional | 55 · Aftercare only | $223.87 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $158.49 Typical High $165.96 | Professional | 56 · Pre-op care only | $147.91 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,096.48 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,096.48 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,071.52 Typical High $1,819.70 | Professional | 62 · Two surgeons | $870.96 | $1,071.52 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $275.42 Typical High $457.09 | Professional | 80 · Assistant surgeon | $223.87 | $275.42 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $239.88 Typical High $398.11 | Professional | AS · PA/NP assist | $194.98 | $239.88 | $398.11 |
Where California sits
The same service costs 19.5 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
$1,950
AK $6,457TX $331
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.