How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,023 to $13,804Professionalmedian $891 · 10th to 90th $676 to $5,754
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 $676.08 Median $724.44 Typical High $776.25 | Professional | None | $676.08 | $724.44 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $11,748.98 Typical High $20,417.38 | Facility | None | $5,888.44 | $11,748.98 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $2,187.76 | Professional | None | $812.83 | $891.25 | $2,187.76 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $10,471.29 | Facility | None | $100.00 | $2,137.96 | $10,471.29 |
Blue Shield Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,174.90 | Professional | None | $575.44 | $851.14 | $1,174.90 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,000.00 | Professional | None | $707.95 | $977.24 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $5,370.32 Typical High $9,120.11 | Facility | None | $851.14 | $5,370.32 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,288.25 | Professional | None | $741.31 | $831.76 | $1,288.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $524.81 Median $870.96 Typical High $1,096.48 | Professional | None | $524.81 | $870.96 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,862.09 | Professional | None | $724.44 | $912.01 | $1,862.09 |
Lucent Health Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $6,456.54 | Professional | None | $5,754.40 | $5,754.40 | $6,456.54 |
Molina Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $851.14 Median $5,128.61 Typical High $9,549.93 | Facility | None | $851.14 | $5,128.61 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,230.27 | Professional | None | $741.31 | $812.83 | $1,230.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,365.16 | $14,454.40 |
United Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,318.26 | Professional | None | $616.60 | $776.25 | $1,318.26 |
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 $338.84 Median $363.08 Typical High $389.05 | Professional | 52 · Reduced service | $338.84 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $154.88 | Professional | 53 · Discontinued | $134.90 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $512.86 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $117.49 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $77.62 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $478.63 | $501.19 | $537.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,230.27 Typical High $2,041.74 | Professional | 50 · Both sides | $977.24 | $1,230.27 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $524.81 Typical High $851.14 | Professional | 62 · Two surgeons | $407.38 | $524.81 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $131.83 Typical High $229.09 | Professional | 80 · Assistant surgeon | $104.71 | $131.83 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $114.82 Typical High $190.55 | Professional | AS · PA/NP assist | $91.20 | $114.82 | $190.55 |
Where California sits
The same service costs 7.4 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· 34th of 51
$912
AK $3,311TX $447
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.