How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,445 to $22,909Professionalmedian $2,089 · 10th to 90th $1,622 to $14,125
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 $2,818.38 Median $9,120.11 Typical High $19,952.62 | Facility | None | $2,818.38 | $9,120.11 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,737.80 Typical High $1,778.28 | Professional | None | $1,621.81 | $1,737.80 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $17,378.01 Typical High $36,307.81 | Facility | None | $7,079.46 | $17,378.01 | $36,307.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,137.96 Typical High $4,897.79 | Professional | None | $2,089.30 | $2,137.96 | $4,897.79 |
Blue Shield Setting Facility Modifier None Typical Low $85.11 Median $3,019.95 Typical High $7,585.78 | Facility | None | $85.11 | $3,019.95 | $7,585.78 |
Blue Shield Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,905.46 | $2,691.53 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $2,570.40 | Professional | None | $1,778.28 | $2,344.23 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $13,182.57 Typical High $23,442.29 | Facility | None | $812.83 | $13,182.57 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,698.24 | $1,995.26 | $2,951.21 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,380.38 | $2,089.30 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,290.87 Typical High $4,570.88 | Professional | None | $1,778.28 | $2,290.87 | $4,570.88 |
Lucent Health Setting Professional Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $17,378.01 | Professional | None | $14,125.38 | $14,125.38 | $17,378.01 |
Molina Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
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 $12,302.69 Typical High $21,877.62 | Facility | None | $870.96 | $12,302.69 | $21,877.62 |
Providence Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,698.24 | $1,995.26 | $2,951.21 |
Sutter Health Plus Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Professional | None | $6,165.95 | $6,165.95 | $6,165.95 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $9,772.37 Typical High $29,512.09 | Facility | None | $4,265.80 | $9,772.37 | $29,512.09 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,905.46 | $3,019.95 |
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 $812.83 Median $870.96 Typical High $891.25 | Professional | 52 · Reduced service | $812.83 | $870.96 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $346.74 Typical High $354.81 | Professional | 53 · Discontinued | $323.59 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,288.25 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,202.26 | $1,288.25 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $257.04 Typical High $269.15 | Professional | 55 · Aftercare only | $239.88 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $173.78 Typical High $177.83 | Professional | 56 · Pre-op care only | $162.18 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,202.26 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,202.26 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,318.26 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,047.13 | $1,318.26 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $331.13 Typical High $549.54 | Professional | 80 · Assistant surgeon | $263.03 | $331.13 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $288.40 Typical High $478.63 | Professional | AS · PA/NP assist | $234.42 | $288.40 | $478.63 |
Where California sits
The same service costs 16.2 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· 39th of 51
$2,138
AK $8,128TX $501
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.