How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,096 to $13,490Professionalmedian $1,413 · 10th to 90th $1,023 to $4,898
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 $1,096.48 Median $1,174.90 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,174.90 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,232.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $3,162.28 | Professional | None | $1,348.96 | $1,445.44 | $3,162.28 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $1,862.09 Typical High $6,606.93 | Facility | None | $95.50 | $1,862.09 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,819.70 | Professional | None | $891.25 | $1,318.26 | $1,819.70 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,445.44 | Professional | None | $831.76 | $1,202.26 | $1,445.44 |
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 $1,096.48 Median $1,258.93 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,258.93 | $2,089.30 |
Contra Costa Health Setting Professional Modifier None Typical Low $549.54 Median $1,318.26 Typical High $1,621.81 | Professional | None | $549.54 | $1,318.26 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,884.03 | Professional | None | $1,071.52 | $1,380.38 | $2,884.03 |
Lucent Health Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Professional | None | $10,000.00 | $10,000.00 | $10,000.00 |
Molina Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $5,370.32 Typical High $8,912.51 | Facility | None | $870.96 | $5,370.32 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,230.27 | $1,995.26 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Professional | None | $4,168.69 | $4,168.69 | $4,168.69 |
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 $1,000.00 Median $1,230.27 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,230.27 | $2,089.30 |
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 $549.54 Median $588.84 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $234.42 Typical High $245.47 | Professional | 53 · Discontinued | $218.78 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $870.96 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $870.96 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $173.78 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $117.49 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $812.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $812.83 | $870.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,995.26 Typical High $3,162.28 | Professional | 50 · Both sides | $1,584.89 | $1,995.26 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $831.76 Typical High $1,318.26 | Professional | 62 · Two surgeons | $660.69 | $831.76 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $213.80 Typical High $338.84 | Professional | 80 · Assistant surgeon | $169.82 | $213.80 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $186.21 Typical High $295.12 | Professional | AS · PA/NP assist | $147.91 | $186.21 | $295.12 |
Where California sits
The same service costs 17.8 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· 37th of 51
$1,413
AK $5,129TX $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.