How much rates vary
Facilitymedian $4,786 · 10th to 90th $813 to $11,749Professionalmedian $646 · 10th to 90th $479 to $4,266
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 $512.86 Typical High $891.25 | Professional | None | $478.63 | $512.86 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,128.31 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $1,445.44 | Professional | None | $537.03 | $645.65 | $1,445.44 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $7,943.28 | Facility | None | $100.00 | $2,137.96 | $7,943.28 |
Blue Shield Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $891.25 | Professional | None | $436.52 | $645.65 | $891.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $724.44 | Professional | None | $446.68 | $630.96 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,370.32 Typical High $9,120.11 | Facility | None | $645.65 | $5,370.32 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $933.25 | Professional | None | $524.81 | $602.56 | $933.25 |
Contra Costa Health Setting Professional Modifier None Typical Low $295.12 Median $645.65 Typical High $794.33 | Professional | None | $295.12 | $645.65 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,318.26 | Professional | None | $549.54 | $676.08 | $1,318.26 |
Lucent Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,677.35 | Professional | None | $4,265.80 | $4,265.80 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
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 $4,897.79 Typical High $8,912.51 | Facility | None | $676.08 | $4,897.79 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $912.01 | Professional | None | $524.81 | $602.56 | $912.01 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $436.52 Median $549.54 Typical High $933.25 | Professional | None | $436.52 | $549.54 | $933.25 |
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 $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 $97.72 Median $102.33 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $56.23 | Professional | 56 · Pre-op care only | $47.86 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $363.08 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $338.84 | $363.08 | $389.05 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $870.96 Typical High $1,445.44 | Professional | 50 · Both sides | $660.69 | $870.96 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $281.84 Median $363.08 Typical High $602.56 | Professional | 62 · Two surgeons | $281.84 | $363.08 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $91.20 Typical High $165.96 | Professional | 80 · Assistant surgeon | $70.79 | $91.20 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $81.28 Typical High $134.90 | Professional | AS · PA/NP assist | $61.66 | $81.28 | $134.90 |
Where California sits
The same service costs 7.6 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· 35th of 51
$676
AK $2,344TX $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.