How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,202 to $14,125Professionalmedian $1,148 · 10th to 90th $851 to $4,169
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 $891.25 Median $933.25 Typical High $1,023.29 | Professional | None | $891.25 | $933.25 | $1,023.29 |
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 $1,122.02 Median $1,174.90 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,174.90 | $2,754.23 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,951.21 Typical High $10,964.78 | Facility | None | $100.00 | $2,951.21 | $10,964.78 |
Blue Shield Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,513.56 | Professional | None | $741.31 | $1,096.48 | $1,513.56 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,202.26 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,466.84 Typical High $8,912.51 | Facility | None | $851.14 | $4,466.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,698.24 | Professional | None | $977.24 | $1,071.52 | $1,698.24 |
Contra Costa Health Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,479.11 | Professional | None | $831.76 | $1,096.48 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $2,290.87 | Professional | None | $891.25 | $1,148.15 | $2,290.87 |
Lucent Health Setting Professional Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $11,748.98 | Professional | None | $11,748.98 | $11,748.98 | $11,748.98 |
Molina Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $912.01 Median $4,265.80 Typical High $10,000.00 | Facility | None | $912.01 | $4,265.80 | $10,000.00 |
Providence Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,621.81 | Professional | None | $977.24 | $1,047.13 | $1,621.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 $794.33 Median $1,000.00 Typical High $1,698.24 | Professional | None | $794.33 | $1,000.00 | $1,698.24 |
10 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 $446.68 Median $467.74 Typical High $512.86 | Professional | 52 · Reduced service | $446.68 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $204.17 | Professional | 53 · Discontinued | $177.83 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $93.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $89.13 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,621.81 Typical High $2,570.40 | Professional | 50 · Both sides | $1,288.25 | $1,621.81 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $676.08 Typical High $1,071.52 | Professional | 62 · Two surgeons | $549.54 | $676.08 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $169.82 Typical High $275.42 | Professional | 80 · Assistant surgeon | $138.04 | $169.82 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $151.36 Typical High $239.88 | Professional | AS · PA/NP assist | $120.23 | $151.36 | $239.88 |
Where California sits
The same service costs 21.4 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
$1,175
AK $4,074TX $191
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.