How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,259 to $15,849Professionalmedian $2,291 · 10th to 90th $1,622 to $7,413
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 $1,737.80 Median $1,819.70 Typical High $1,949.84 | Professional | None | $1,737.80 | $1,819.70 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $13,182.57 Typical High $23,442.29 | Facility | None | $6,760.83 | $13,182.57 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $4,786.30 | Professional | None | $1,905.46 | $2,344.23 | $4,786.30 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $6,025.60 Typical High $12,302.69 | Facility | None | $69.18 | $6,025.60 | $12,302.69 |
Blue Shield Setting Professional Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,090.30 | Professional | None | $1,513.56 | $2,238.72 | $3,090.30 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,949.84 | $1,949.84 |
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 $1,862.09 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,862.09 | $2,089.30 | $3,162.28 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,737.80 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $4,073.80 | Professional | None | $1,479.11 | $1,862.09 | $4,073.80 |
Lucent Health Setting Professional Modifier None Typical Low $19,054.61 Median $19,054.61 Typical High $19,054.61 | Professional | None | $19,054.61 | $19,054.61 | $19,054.61 |
Molina Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
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 $1,862.09 Median $2,089.30 Typical High $3,019.95 | Professional | None | $1,862.09 | $2,089.30 | $3,019.95 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
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 $1,412.54 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,412.54 | $1,862.09 | $2,951.21 |
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 $870.96 Median $912.01 Typical High $977.24 | Professional | 52 · Reduced service | $870.96 | $912.01 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $363.08 Typical High $389.05 | Professional | 53 · Discontinued | $346.74 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,380.38 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,288.25 | $1,380.38 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $275.42 Typical High $295.12 | Professional | 55 · Aftercare only | $257.04 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $181.97 Typical High $194.98 | Professional | 56 · Pre-op care only | $173.78 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,288.25 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,288.25 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $302.00 Typical High $489.78 | Professional | 80 · Assistant surgeon | $239.88 | $302.00 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $263.03 Typical High $426.58 | Professional | AS · PA/NP assist | $213.80 | $263.03 | $426.58 |
Where California sits
The same service costs 20.0 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· 31st of 51
$2,291
AK $7,244TX $363
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.