How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,380 to $13,804Professionalmedian $1,622 · 10th to 90th $1,202 to $5,623
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 $1,202.26 Median $1,288.25 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,288.25 | $1,412.54 |
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 $1,548.82 Median $1,659.59 Typical High $3,548.13 | Professional | None | $1,548.82 | $1,659.59 | $3,548.13 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $2,691.53 Typical High $7,079.46 | Facility | None | $95.50 | $2,691.53 | $7,079.46 |
Blue Shield Setting Professional Modifier None Typical Low $1,000.00 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,479.11 | $2,041.74 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,348.96 | $1,659.59 | $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 $1,318.26 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,513.56 | $2,344.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $1,995.26 | Professional | None | $1,122.02 | $1,479.11 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $3,235.94 | Professional | None | $1,230.27 | $1,548.82 | $3,235.94 |
Lucent Health Setting Professional Modifier None Typical Low $17,782.79 Median $17,782.79 Typical High $17,782.79 | Professional | None | $17,782.79 | $17,782.79 | $17,782.79 |
Molina Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $1,318.26 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,513.56 | $2,290.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
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 $1,122.02 Median $1,380.38 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,380.38 | $2,398.83 |
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 $616.60 Median $645.65 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $645.65 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $257.04 Typical High $275.42 | Professional | 53 · Discontinued | $245.47 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $977.24 Typical High $1,047.13 | Professional | 54 · Surgery only | $912.01 | $977.24 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $194.98 Typical High $208.93 | Professional | 55 · Aftercare only | $181.97 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $128.82 Typical High $138.04 | Professional | 56 · Pre-op care only | $123.03 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $912.01 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $851.14 | $912.01 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $239.88 Typical High $371.54 | Professional | 80 · Assistant surgeon | $194.98 | $239.88 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $208.93 Typical High $323.59 | Professional | AS · PA/NP assist | $169.82 | $208.93 | $323.59 |
Where California sits
The same service costs 19.5 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· 35th of 51
$1,622
AK $5,754TX $295
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.