How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,202 to $13,183Professionalmedian $1,318 · 10th to 90th $977 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 $2,238.72 Median $7,585.78 Typical High $18,197.01 | Facility | None | $2,238.72 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,096.48 | Professional | None | $954.99 | $1,023.29 | $1,096.48 |
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 $1,288.25 Typical High $2,951.21 | Professional | None | $1,202.26 | $1,288.25 | $2,951.21 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,162.28 Typical High $10,471.29 | Facility | None | $100.00 | $3,162.28 | $10,471.29 |
Blue Shield Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $1,995.26 | Professional | None | $977.24 | $1,445.44 | $1,995.26 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $1,380.38 | Professional | None | $954.99 | $1,288.25 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,311.31 Typical High $6,606.93 | Facility | None | $758.58 | $3,311.31 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,288.25 | $1,995.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $741.31 Median $1,174.90 Typical High $1,445.44 | Professional | None | $741.31 | $1,174.90 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $2,570.40 | Professional | None | $977.24 | $1,230.27 | $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 $812.83 Median $3,235.94 Typical High $7,413.10 | Facility | None | $812.83 | $3,235.94 | $7,413.10 |
Providence Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,258.93 | $1,862.09 |
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 $2,290.87 Median $5,495.41 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,495.41 | $17,378.01 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,819.70 | Professional | None | $870.96 | $1,148.15 | $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 $512.86 Typical High $549.54 | Professional | 52 · Reduced service | $478.63 | $512.86 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $218.78 | Professional | 53 · Discontinued | $194.98 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $776.25 Typical High $812.83 | Professional | 54 · Surgery only | $724.44 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $154.88 Typical High $162.18 | Professional | 55 · Aftercare only | $144.54 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $109.65 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $724.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $676.08 | $724.44 | $758.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,737.80 Typical High $2,884.03 | Professional | 50 · Both sides | $1,380.38 | $1,737.80 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $741.31 Typical High $1,230.27 | Professional | 62 · Two surgeons | $575.44 | $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 $162.18 Typical High $269.15 | Professional | AS · PA/NP assist | $128.82 | $162.18 | $269.15 |
Where California sits
The same service costs 19.5 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· 33rd of 51
$1,413
AK $4,571TX $234
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.