How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,445 to $15,136Professionalmedian $2,239 · 10th to 90th $1,660 to $8,710
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 $1,905.46 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,905.46 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $1,905.46 | Professional | None | $1,659.59 | $1,778.28 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $11,481.54 Typical High $21,379.62 | Facility | None | $6,025.60 | $11,481.54 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $2,290.87 Typical High $5,495.41 | Professional | None | $2,238.72 | $2,290.87 | $5,495.41 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,951.21 Typical High $14,125.38 | Facility | None | $100.00 | $2,951.21 | $14,125.38 |
Blue Shield Setting Professional Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,412.54 | $2,089.30 | $2,884.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,630.27 Typical High $2,951.21 | Professional | None | $2,041.74 | $2,630.27 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,466.84 Typical High $9,120.11 | Facility | None | $758.58 | $4,466.84 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $3,715.35 | Professional | None | $1,778.28 | $1,995.26 | $3,715.35 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $2,951.21 | Professional | None | $1,548.82 | $2,344.23 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $5,128.61 | Professional | None | $1,949.84 | $2,454.71 | $5,128.61 |
Lucent Health Setting Professional Modifier None Typical Low $25,703.96 Median $25,703.96 Typical High $25,703.96 | Professional | None | $25,703.96 | $25,703.96 | $25,703.96 |
Molina Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
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 $831.76 Median $4,265.80 Typical High $8,511.38 | Facility | None | $831.76 | $4,265.80 | $8,511.38 |
Providence Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $3,548.13 | Professional | None | $1,778.28 | $1,949.84 | $3,548.13 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | None | $7,413.10 | $7,413.10 | $7,413.10 |
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 $1,659.59 Median $2,137.96 Typical High $3,801.89 | Professional | None | $1,659.59 | $2,137.96 | $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 $831.76 Median $870.96 Typical High $954.99 | Professional | 52 · Reduced service | $831.76 | $870.96 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $354.81 Typical High $380.19 | Professional | 53 · Discontinued | $338.84 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,318.26 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,258.93 | $1,318.26 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $263.03 Typical High $281.84 | Professional | 55 · Aftercare only | $251.19 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $177.83 Typical High $190.55 | Professional | 56 · Pre-op care only | $165.96 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,230.27 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,230.27 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,479.11 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,202.26 | $1,479.11 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $380.19 Typical High $562.34 | Professional | 80 · Assistant surgeon | $302.00 | $380.19 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $331.13 Typical High $489.78 | Professional | AS · PA/NP assist | $263.03 | $331.13 | $489.78 |
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· 38th of 51
$2,291
AK $9,120TX $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.