How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,202 to $20,893Professionalmedian $2,951 · 10th to 90th $2,138 to $19,055
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 $2,238.72 Median $2,398.83 Typical High $2,511.89 | Professional | None | $2,238.72 | $2,398.83 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $14,125.38 Typical High $25,118.86 | Facility | None | $7,244.36 | $14,125.38 | $25,118.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $3,019.95 Typical High $6,309.57 | Professional | None | $2,691.53 | $3,019.95 | $6,309.57 |
Blue Shield Setting Facility Modifier None Typical Low $85.11 Median $2,089.30 Typical High $10,232.93 | Facility | None | $85.11 | $2,089.30 | $10,232.93 |
Blue Shield Setting Professional Modifier None Typical Low $1,778.28 Median $2,630.27 Typical High $3,630.78 | Professional | None | $1,778.28 | $2,630.27 | $3,630.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,691.53 Typical High $3,630.78 | Professional | None | $2,238.72 | $2,691.53 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $12,882.50 Typical High $22,908.68 | Facility | None | $794.33 | $12,882.50 | $22,908.68 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $2,754.23 Typical High $3,981.07 | Professional | None | $2,344.23 | $2,754.23 | $3,981.07 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $3,311.31 | Professional | None | $1,949.84 | $2,454.71 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,630.27 Typical High $5,370.32 | Professional | None | $2,041.74 | $2,630.27 | $5,370.32 |
Lucent Health Setting Professional Modifier None Typical Low $19,054.61 Median $21,877.62 Typical High $21,877.62 | Professional | None | $19,054.61 | $21,877.62 | $21,877.62 |
Molina Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
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 $12,022.64 Typical High $21,379.62 | Facility | None | $870.96 | $12,022.64 | $21,379.62 |
Providence Setting Professional Modifier None Typical Low $2,344.23 Median $2,754.23 Typical High $3,890.45 | Professional | None | $2,344.23 | $2,754.23 | $3,890.45 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Professional | None | $7,943.28 | $7,943.28 | $7,943.28 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $9,772.37 Typical High $30,199.52 | Facility | None | $4,265.80 | $9,772.37 | $30,199.52 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $2,511.89 Typical High $4,073.80 | Professional | None | $1,949.84 | $2,511.89 | $4,073.80 |
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 $1,122.02 Median $1,202.26 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,122.02 | $1,202.26 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $478.63 Typical High $501.19 | Professional | 53 · Discontinued | $457.09 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,819.70 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,698.24 | $1,819.70 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $363.08 Typical High $371.54 | Professional | 55 · Aftercare only | $338.84 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $239.88 Typical High $251.19 | Professional | 56 · Pre-op care only | $223.87 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,698.24 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,698.24 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,659.59 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,348.96 | $1,659.59 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $416.87 Typical High $676.08 | Professional | 80 · Assistant surgeon | $346.74 | $416.87 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $363.08 Typical High $588.84 | Professional | AS · PA/NP assist | $302.00 | $363.08 | $588.84 |
Where California sits
The same service costs 25.7 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
$2,951
AK $10,000TX $389
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.