How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,072 to $16,218Professionalmedian $1,230 · 10th to 90th $933 to $8,128
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 $1,071.52 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,071.52 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,071.52 | Professional | None | $954.99 | $1,000.00 | $1,071.52 |
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 $1,202.26 Median $1,258.93 Typical High $3,019.95 | Professional | None | $1,202.26 | $1,258.93 | $3,019.95 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $1,905.46 Typical High $6,606.93 | Facility | None | $91.20 | $1,905.46 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,548.82 | Professional | None | $758.58 | $1,096.48 | $1,548.82 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,445.44 | Professional | None | $977.24 | $1,318.26 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $9,549.93 Typical High $16,982.44 | Facility | None | $794.33 | $9,549.93 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,148.15 | $1,819.70 |
Contra Costa Health Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $1,479.11 | Professional | None | $758.58 | $1,174.90 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,570.40 | Professional | None | $977.24 | $1,258.93 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,912.51 | Professional | None | $8,128.31 | $8,128.31 | $8,912.51 |
Molina Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $8,912.51 Typical High $15,848.93 | Facility | None | $870.96 | $8,912.51 | $15,848.93 |
Providence Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,122.02 | $1,737.80 |
Sutter Health Plus 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 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $20,417.38 | Facility | None | $2,884.03 | $6,760.83 | $20,417.38 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,819.70 | Professional | None | $870.96 | $1,096.48 | $1,819.70 |
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 $478.63 Median $501.19 Typical High $537.03 | Professional | 52 · Reduced service | $478.63 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $199.53 Typical High $213.80 | Professional | 53 · Discontinued | $190.55 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $794.33 | Professional | 54 · Surgery only | $707.95 | $758.58 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $100.00 Typical High $107.15 | Professional | 56 · Pre-op care only | $95.50 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $707.95 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $660.69 | $707.95 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,778.28 Typical High $2,951.21 | Professional | 50 · Both sides | $1,380.38 | $1,778.28 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $741.31 Typical High $1,230.27 | Professional | 62 · Two surgeons | $588.84 | $741.31 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $186.21 Typical High $309.03 | Professional | 80 · Assistant surgeon | $147.91 | $186.21 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $165.96 Typical High $275.42 | Professional | AS · PA/NP assist | $128.82 | $165.96 | $275.42 |
Where California sits
The same service costs 8.3 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· 36th of 51
$1,259
AK $4,571TX $550
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.