How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,413 to $16,218Professionalmedian $3,236 · 10th to 90th $2,344 to $11,220
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 $2,691.53 Median $7,585.78 Typical High $18,197.01 | Facility | None | $2,691.53 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $2,691.53 | Professional | None | $2,398.83 | $2,511.89 | $2,691.53 |
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 $3,019.95 Median $3,235.94 Typical High $7,413.10 | Professional | None | $3,019.95 | $3,235.94 | $7,413.10 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $8,912.51 Typical High $19,054.61 | Facility | None | $69.18 | $8,912.51 | $19,054.61 |
Blue Shield Setting Professional Modifier None Typical Low $2,187.76 Median $3,235.94 Typical High $4,466.84 | Professional | None | $2,187.76 | $3,235.94 | $4,466.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,884.03 Typical High $2,951.21 | Professional | None | $2,041.74 | $2,884.03 | $2,951.21 |
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 $2,511.89 Median $2,951.21 Typical High $4,466.84 | Professional | None | $2,511.89 | $2,951.21 | $4,466.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,691.53 Typical High $3,311.31 | Professional | None | $1,348.96 | $2,691.53 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,238.72 Median $2,884.03 Typical High $6,165.95 | Professional | None | $2,238.72 | $2,884.03 | $6,165.95 |
Lucent Health Setting Professional Modifier None Typical Low $33,113.11 Median $33,113.11 Typical High $33,113.11 | Professional | None | $33,113.11 | $33,113.11 | $33,113.11 |
Molina Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
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 $5,370.32 Typical High $8,912.51 | Facility | None | $870.96 | $5,370.32 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $2,511.89 Median $2,951.21 Typical High $4,466.84 | Professional | None | $2,511.89 | $2,951.21 | $4,466.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Professional | None | $9,120.11 | $9,120.11 | $9,120.11 |
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 $2,187.76 Median $2,754.23 Typical High $4,570.88 | Professional | None | $2,187.76 | $2,754.23 | $4,570.88 |
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 $1,202.26 Median $1,258.93 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,202.26 | $1,258.93 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $501.19 Typical High $537.03 | Professional | 53 · Discontinued | $478.63 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,862.09 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,778.28 | $1,862.09 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $371.54 Typical High $398.11 | Professional | 55 · Aftercare only | $354.81 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $251.19 Typical High $269.15 | Professional | 56 · Pre-op care only | $239.88 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,737.80 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,737.80 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $467.74 Typical High $776.25 | Professional | 80 · Assistant surgeon | $371.54 | $467.74 | $776.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $416.87 Typical High $676.08 | Professional | AS · PA/NP assist | $323.59 | $416.87 | $676.08 |
Where California sits
The same service costs 20.9 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
$3,236
AK $11,220TX $537
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.