How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,318 to $13,804Professionalmedian $1,413 · 10th to 90th $1,047 to $4,898
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 $2,570.40 Median $8,912.51 Typical High $19,054.61 | Facility | None | $2,570.40 | $8,912.51 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,202.26 | $1,288.25 |
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 $1,318.26 Median $1,412.54 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,412.54 | $3,090.30 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,754.23 Typical High $6,606.93 | Facility | None | $100.00 | $2,754.23 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,862.09 | Professional | None | $891.25 | $1,318.26 | $1,862.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,445.44 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,466.84 Typical High $9,120.11 | Facility | None | $794.33 | $4,466.84 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,288.25 | $2,041.74 |
Contra Costa Health Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $1,698.24 | Professional | None | $891.25 | $1,288.25 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $3,388.44 | Professional | None | $1,071.52 | $1,348.96 | $3,388.44 |
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 $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $4,265.80 Typical High $8,511.38 | Facility | None | $870.96 | $4,265.80 | $8,511.38 |
Providence Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,258.93 | $1,949.84 |
Sutter Health Plus 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 |
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 $977.24 Median $1,230.27 Typical High $2,089.30 | Professional | None | $977.24 | $1,230.27 | $2,089.30 |
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 $562.34 Median $602.56 Typical High $645.65 | Professional | 52 · Reduced service | $562.34 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $239.88 Typical High $257.04 | Professional | 53 · Discontinued | $229.09 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $912.01 Typical High $954.99 | Professional | 54 · Surgery only | $851.14 | $912.01 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $181.97 Typical High $190.55 | Professional | 55 · Aftercare only | $169.82 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $120.23 Typical High $128.82 | Professional | 56 · Pre-op care only | $112.20 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $851.14 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $794.33 | $851.14 | $891.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $831.76 Typical High $1,380.38 | Professional | 62 · Two surgeons | $676.08 | $831.76 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $208.93 Typical High $354.81 | Professional | 80 · Assistant surgeon | $169.82 | $208.93 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $181.97 Typical High $309.03 | Professional | AS · PA/NP assist | $147.91 | $181.97 | $309.03 |
Where California sits
The same service costs 14.5 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· 36th of 51
$1,413
AK $4,898TX $339
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.