How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,122 to $15,136Professionalmedian $1,349 · 10th to 90th $741 to $9,772
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 $1,071.52 Median $1,122.02 Typical High $1,202.26 | Professional | None | $1,071.52 | $1,122.02 | $1,202.26 |
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 $1,096.48 Median $1,380.38 Typical High $2,818.38 | Professional | None | $1,096.48 | $1,380.38 | $2,818.38 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $14,454.40 | Facility | None | $100.00 | $2,137.96 | $14,454.40 |
Blue Shield Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $1,096.48 | Professional | None | $537.03 | $794.33 | $1,096.48 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,548.82 | Professional | None | $954.99 | $1,348.96 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $7,244.36 Typical High $12,302.69 | Facility | None | $645.65 | $7,244.36 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,348.96 Typical High $2,089.30 | Professional | None | $741.31 | $1,348.96 | $2,089.30 |
Contra Costa Health Setting Professional Modifier None Typical Low $630.96 Median $1,380.38 Typical High $1,737.80 | Professional | None | $630.96 | $1,380.38 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $3,090.30 | Professional | None | $1,148.15 | $1,479.11 | $3,090.30 |
Lucent Health Setting Professional Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $10,715.19 | Professional | None | $9,772.37 | $9,772.37 | $10,715.19 |
Molina Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
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 $758.58 Median $6,456.54 Typical High $11,481.54 | Facility | None | $758.58 | $6,456.54 | $11,481.54 |
Providence Setting Professional Modifier None Typical Low $741.31 Median $1,348.96 Typical High $2,089.30 | Professional | None | $741.31 | $1,348.96 | $2,089.30 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,754.40 | $17,378.01 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $2,187.76 | Professional | None | $812.83 | $1,258.93 | $2,187.76 |
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 $537.03 Median $562.34 Typical High $588.84 | Professional | 52 · Reduced service | $537.03 | $562.34 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $223.87 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $851.14 Typical High $891.25 | Professional | 54 · Surgery only | $794.33 | $851.14 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $169.82 Typical High $177.83 | Professional | 55 · Aftercare only | $158.49 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $112.20 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $794.33 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $741.31 | $794.33 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $2,089.30 Typical High $3,162.28 | Professional | 50 · Both sides | $1,584.89 | $2,089.30 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $870.96 Typical High $1,318.26 | Professional | 62 · Two surgeons | $660.69 | $870.96 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $218.78 Typical High $338.84 | Professional | 80 · Assistant surgeon | $165.96 | $218.78 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $194.98 Typical High $295.12 | Professional | AS · PA/NP assist | $147.91 | $194.98 | $295.12 |
Where California sits
The same service costs 8.9 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· 37th of 51
$1,380
AK $5,495TX $617
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.