How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,230 to $14,791Professionalmedian $1,820 · 10th to 90th $1,413 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 $1,412.54 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,412.54 | $1,659.59 | $1,737.80 |
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 $1,778.28 Median $1,949.84 Typical High $4,168.69 | Professional | None | $1,778.28 | $1,949.84 | $4,168.69 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $3,388.44 Typical High $6,918.31 | Facility | None | $69.18 | $3,388.44 | $6,918.31 |
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 $1,445.44 Median $1,949.84 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,949.84 | $2,089.30 |
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 $1,548.82 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,548.82 | $1,819.70 | $2,818.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,737.80 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $4,677.35 | Professional | None | $1,445.44 | $1,862.09 | $4,677.35 |
Lucent Health Setting Professional Modifier None Typical Low $15,488.17 Median $15,488.17 Typical High $15,488.17 | Professional | None | $15,488.17 | $15,488.17 | $15,488.17 |
Molina Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $1,548.82 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,548.82 | $1,819.70 | $2,691.53 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | None | $5,623.41 | $5,623.41 | $5,623.41 |
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 $1,348.96 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,348.96 | $1,659.59 | $2,884.03 |
8 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 $724.44 Median $758.58 Typical High $831.76 | Professional | 52 · Reduced service | $724.44 | $758.58 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $309.03 Typical High $331.13 | Professional | 53 · Discontinued | $288.40 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,148.15 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,096.48 | $1,148.15 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $229.09 Typical High $245.47 | Professional | 55 · Aftercare only | $218.78 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $165.96 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,071.52 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,071.52 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $288.40 Typical High $416.87 | Professional | 80 · Assistant surgeon | $234.42 | $288.40 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $251.19 Typical High $363.08 | Professional | AS · PA/NP assist | $204.17 | $251.19 | $363.08 |
Where California sits
The same service costs 18.2 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
$1,905
AK $6,918TX $380
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.