How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,514 to $14,125Professionalmedian $2,630 · 10th to 90th $1,905 to $9,120
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 $1,949.84 Median $2,041.74 Typical High $2,187.76 | Professional | None | $1,949.84 | $2,041.74 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,232.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,454.71 Median $2,691.53 Typical High $6,025.60 | Professional | None | $2,454.71 | $2,691.53 | $6,025.60 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $2,884.03 Typical High $10,471.29 | Facility | None | $95.50 | $2,884.03 | $10,471.29 |
Blue Shield Setting Professional Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $3,467.37 | Professional | None | $1,698.24 | $2,511.89 | $3,467.37 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,511.89 Typical High $2,818.38 | Professional | None | $1,905.46 | $2,511.89 | $2,818.38 |
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 $2,137.96 Median $2,398.83 Typical High $3,715.35 | Professional | None | $2,137.96 | $2,398.83 | $3,715.35 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $2,818.38 | Professional | None | $1,479.11 | $2,238.72 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,905.46 Median $2,398.83 Typical High $5,128.61 | Professional | None | $1,905.46 | $2,398.83 | $5,128.61 |
Lucent Health Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $22,387.21 | Professional | None | $22,387.21 | $22,387.21 | $22,387.21 |
Molina Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
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 $2,137.96 Median $2,344.23 Typical High $3,630.78 | Professional | None | $2,137.96 | $2,344.23 | $3,630.78 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
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 $1,819.70 Median $2,290.87 Typical High $3,801.89 | Professional | None | $1,819.70 | $2,290.87 | $3,801.89 |
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 $977.24 Median $1,023.29 Typical High $1,096.48 | Professional | 52 · Reduced service | $977.24 | $1,023.29 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $407.38 Typical High $436.52 | Professional | 53 · Discontinued | $389.05 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,548.82 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,445.44 | $1,548.82 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $309.03 Typical High $323.59 | Professional | 55 · Aftercare only | $288.40 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $204.17 Typical High $218.78 | Professional | 56 · Pre-op care only | $194.98 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,445.44 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,445.44 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,513.56 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,202.26 | $1,513.56 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $389.05 Typical High $645.65 | Professional | 80 · Assistant surgeon | $309.03 | $389.05 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $338.84 Typical High $562.34 | Professional | AS · PA/NP assist | $269.15 | $338.84 | $562.34 |
Where California sits
The same service costs 21.9 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· 35th of 51
$2,630
AK $9,333TX $427
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.