How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,622 to $16,982Professionalmedian $1,820 · 10th to 90th $1,318 to $6,607
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 $2,398.83 Median $9,120.11 Typical High $21,379.62 | Facility | None | $2,398.83 | $9,120.11 | $21,379.62 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $1,621.81 | Professional | None | $1,412.54 | $1,513.56 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $13,182.57 Typical High $23,442.29 | Facility | None | $6,760.83 | $13,182.57 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $3,890.45 | Professional | None | $1,445.44 | $1,819.70 | $3,890.45 |
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 $1,148.15 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,698.24 | $2,344.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,584.89 | $1,949.84 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $7,413.10 Typical High $12,589.25 | Facility | None | $1,148.15 | $7,413.10 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,659.59 | $2,691.53 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,344.23 | Professional | None | $1,445.44 | $1,819.70 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $3,715.35 | Professional | None | $1,412.54 | $1,819.70 | $3,715.35 |
Lucent Health Setting Professional Modifier None Typical Low $25,118.86 Median $25,118.86 Typical High $25,118.86 | Professional | None | $25,118.86 | $25,118.86 | $25,118.86 |
Molina Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
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 $1,174.90 Median $7,079.46 Typical High $12,589.25 | Facility | None | $1,174.90 | $7,079.46 | $12,589.25 |
Providence Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,513.56 | $1,621.81 | $2,570.40 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
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 $1,258.93 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,258.93 | $1,548.82 | $2,691.53 |
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 $707.95 Median $741.31 Typical High $812.83 | Professional | 52 · Reduced service | $707.95 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $302.00 Typical High $323.59 | Professional | 53 · Discontinued | $281.84 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,122.02 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,047.13 | $1,122.02 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $223.87 Typical High $239.88 | Professional | 55 · Aftercare only | $208.93 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $151.36 Typical High $162.18 | Professional | 56 · Pre-op care only | $141.25 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $977.24 | $1,047.13 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,570.40 Typical High $3,801.89 | Professional | 50 · Both sides | $2,041.74 | $2,570.40 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,071.52 Typical High $1,584.89 | Professional | 62 · Two surgeons | $870.96 | $1,071.52 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $269.15 Typical High $407.38 | Professional | 80 · Assistant surgeon | $218.78 | $269.15 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $239.88 Typical High $354.81 | Professional | AS · PA/NP assist | $190.55 | $239.88 | $354.81 |
Where California sits
The same service costs 20.0 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
$1,820
AK $6,457TX $324
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.