How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,230 to $14,125Professionalmedian $1,660 · 10th to 90th $1,288 to $15,136
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 $19,498.45 | Facility | None | $2,570.40 | $8,912.51 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,479.11 | Professional | None | $1,288.25 | $1,348.96 | $1,479.11 |
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 $1,659.59 Median $1,698.24 Typical High $4,168.69 | Professional | None | $1,659.59 | $1,698.24 | $4,168.69 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $2,089.30 Typical High $7,585.78 | Facility | None | $97.72 | $2,089.30 | $7,585.78 |
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 $1,445.44 Median $2,041.74 Typical High $2,187.76 | Professional | None | $1,445.44 | $2,041.74 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,495.41 Typical High $10,715.19 | Facility | None | $758.58 | $5,495.41 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,380.38 | $1,548.82 | $2,691.53 |
Contra Costa Health Setting Professional Modifier None Typical Low $954.99 Median $1,949.84 Typical High $2,454.71 | Professional | None | $954.99 | $1,949.84 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $4,168.69 | Professional | None | $1,659.59 | $2,089.30 | $4,168.69 |
Lucent Health Setting Professional Modifier None Typical Low $15,135.61 Median $15,135.61 Typical High $15,848.93 | Professional | None | $15,135.61 | $15,135.61 | $15,848.93 |
Molina Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
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 $5,128.61 Typical High $10,232.93 | Facility | None | $831.76 | $5,128.61 | $10,232.93 |
Providence Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,548.82 | $2,630.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,495.41 | $5,495.41 | $5,495.41 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $18,620.87 | Facility | None | $2,884.03 | $6,760.83 | $18,620.87 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,659.59 | $2,691.53 |
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 $645.65 Median $676.08 Typical High $707.95 | Professional | 52 · Reduced service | $645.65 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $269.15 Typical High $288.40 | Professional | 53 · Discontinued | $257.04 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,023.29 Typical High $1,071.52 | Professional | 54 · Surgery only | $954.99 | $1,023.29 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $204.17 Typical High $213.80 | Professional | 55 · Aftercare only | $190.55 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $144.54 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $954.99 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $891.25 | $954.99 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,148.15 Typical High $1,949.84 | Professional | 62 · Two surgeons | $912.01 | $1,148.15 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $295.12 Typical High $501.19 | Professional | 80 · Assistant surgeon | $234.42 | $295.12 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $257.04 Typical High $436.52 | Professional | AS · PA/NP assist | $204.17 | $257.04 | $436.52 |
Where California sits
The same service costs 11.2 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· 44th of 51
$1,698
AK $7,244TX $646
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.