How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,122 to $13,183Professionalmedian $1,549 · 10th to 90th $1,072 to $10,471
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 $1,202.26 Median $1,288.25 Typical High $1,348.96 | Professional | None | $1,202.26 | $1,288.25 | $1,348.96 |
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 $1,230.27 Median $1,584.89 Typical High $3,548.13 | Professional | None | $1,230.27 | $1,584.89 | $3,548.13 |
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 $794.33 Median $1,174.90 Typical High $1,621.81 | Professional | None | $794.33 | $1,174.90 | $1,621.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,659.59 | $1,698.24 |
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 $1,000.00 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,479.11 | $2,344.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $891.25 Median $1,479.11 Typical High $1,862.09 | Professional | None | $891.25 | $1,479.11 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $3,311.31 | Professional | None | $1,258.93 | $1,584.89 | $3,311.31 |
Lucent Health Setting Professional Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $11,481.54 | Professional | None | $10,471.29 | $10,471.29 | $11,481.54 |
Molina Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $5,011.87 Typical High $9,120.11 | Facility | None | $758.58 | $5,011.87 | $9,120.11 |
Providence Setting Professional Modifier None Typical Low $1,000.00 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,000.00 | $1,479.11 | $2,290.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
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 $1,000.00 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,000.00 | $1,412.54 | $2,398.83 |
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 $602.56 Median $645.65 Typical High $676.08 | Professional | 52 · Reduced service | $602.56 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $257.04 Typical High $269.15 | Professional | 53 · Discontinued | $239.88 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $954.99 Typical High $1,023.29 | Professional | 54 · Surgery only | $912.01 | $954.99 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $204.17 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $128.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $120.23 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $891.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $851.14 | $891.25 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,290.87 Typical High $3,467.37 | Professional | 50 · Both sides | $1,819.70 | $2,290.87 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $933.25 Typical High $1,445.44 | Professional | 62 · Two surgeons | $758.58 | $933.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $239.88 Typical High $371.54 | Professional | 80 · Assistant surgeon | $194.98 | $239.88 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $213.80 Typical High $323.59 | Professional | AS · PA/NP assist | $169.82 | $213.80 | $323.59 |
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· 36th of 51
$1,549
AK $6,026TX $676
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.