How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,380 to $13,804Professionalmedian $1,585 · 10th to 90th $1,148 to $5,495
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 $1,230.27 Median $1,288.25 Typical High $1,412.54 | Professional | None | $1,230.27 | $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 $1,479.11 Median $1,621.81 Typical High $3,388.44 | Professional | None | $1,479.11 | $1,621.81 | $3,388.44 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $2,754.23 Typical High $7,079.46 | Facility | None | $95.50 | $2,754.23 | $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 $1,318.26 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,318.26 | $1,621.81 | $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 $1,258.93 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,445.44 | $2,290.87 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,445.44 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $3,090.30 | Professional | None | $1,174.90 | $1,513.56 | $3,090.30 |
Lucent Health Setting Professional Modifier None Typical Low $11,481.54 Median $11,481.54 Typical High $11,481.54 | Professional | None | $11,481.54 | $11,481.54 | $11,481.54 |
Molina Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $1,258.93 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,412.54 | $2,187.76 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
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 $1,071.52 Median $1,348.96 Typical High $2,344.23 | Professional | None | $1,071.52 | $1,348.96 | $2,344.23 |
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 $616.60 Median $645.65 Typical High $707.95 | Professional | 52 · Reduced service | $616.60 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $281.84 | Professional | 53 · Discontinued | $245.47 | $263.03 | $281.84 |
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 $213.80 | Professional | 55 · Aftercare only | $181.97 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $128.82 Typical High $141.25 | Professional | 56 · Pre-op care only | $123.03 | $128.82 | $141.25 |
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 50 · Both sides Typical Low $1,778.28 Median $2,187.76 Typical High $3,235.94 | Professional | 50 · Both sides | $1,778.28 | $2,187.76 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $912.01 Typical High $1,348.96 | Professional | 62 · Two surgeons | $741.31 | $912.01 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $234.42 Typical High $338.84 | Professional | 80 · Assistant surgeon | $190.55 | $234.42 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $204.17 Typical High $302.00 | Professional | AS · PA/NP assist | $165.96 | $204.17 | $302.00 |
Where California sits
The same service costs 18.6 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· 33rd of 51
$1,622
AK $5,370TX $288
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.