How much rates vary
Facilitymedian $5,623 · 10th to 90th $832 to $13,490Professionalmedian $617 · 10th to 90th $479 to $4,169
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 $2,238.72 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,238.72 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $891.25 | Professional | None | $478.63 | $537.03 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,511.38 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,513.56 | Professional | None | $616.60 | $616.60 | $1,513.56 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,570.40 Typical High $8,912.51 | Facility | None | $100.00 | $2,570.40 | $8,912.51 |
Blue Shield Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $831.76 | Professional | None | $407.38 | $602.56 | $831.76 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $794.33 | Professional | None | $549.54 | $724.44 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,760.83 Typical High $11,481.54 | Facility | None | $645.65 | $6,760.83 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $933.25 | Professional | None | $524.81 | $588.84 | $933.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $812.83 | Professional | None | $426.58 | $645.65 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,348.96 | Professional | None | $549.54 | $676.08 | $1,348.96 |
Lucent Health Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,786.30 | Professional | None | $4,168.69 | $4,168.69 | $4,786.30 |
Molina Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
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 $676.08 Median $5,888.44 Typical High $10,715.19 | Facility | None | $676.08 | $5,888.44 | $10,715.19 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $912.01 | Professional | None | $512.86 | $575.44 | $912.01 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $446.68 Median $562.34 Typical High $954.99 | Professional | None | $446.68 | $562.34 | $954.99 |
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 $239.88 Median $257.04 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $109.65 | Professional | 53 · Discontinued | $95.50 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $380.19 Typical High $407.38 | Professional | 54 · Surgery only | $354.81 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $81.28 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $354.81 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $331.13 | $354.81 | $380.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $891.25 Typical High $1,479.11 | Professional | 50 · Both sides | $707.95 | $891.25 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $95.50 Typical High $158.49 | Professional | 80 · Assistant surgeon | $75.86 | $95.50 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $83.18 Typical High $138.04 | Professional | AS · PA/NP assist | $66.07 | $83.18 | $138.04 |
Where California sits
The same service costs 7.8 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· 40th of 51
$631
AK $2,399TX $309
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.