How much rates vary
Facilitymedian $5,370 · 10th to 90th $977 to $12,882Professionalmedian $955 · 10th to 90th $724 to $6,310
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 $724.44 Median $776.25 Typical High $851.14 | Professional | None | $724.44 | $776.25 | $851.14 |
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 $851.14 Median $954.99 Typical High $2,187.76 | Professional | None | $851.14 | $954.99 | $2,187.76 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,467.37 Typical High $8,317.64 | Facility | None | $100.00 | $3,467.37 | $8,317.64 |
Blue Shield Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,380.38 | Professional | None | $676.08 | $1,000.00 | $1,380.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,174.90 | Professional | None | $794.33 | $1,122.02 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,456.54 Typical High $11,481.54 | Facility | None | $645.65 | $6,456.54 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,445.44 | Professional | None | $776.25 | $912.01 | $1,445.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $524.81 Median $1,047.13 Typical High $1,318.26 | Professional | None | $524.81 | $1,047.13 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $2,089.30 | Professional | None | $851.14 | $1,071.52 | $2,089.30 |
Lucent Health Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $7,413.10 | Professional | None | $6,309.57 | $6,309.57 | $7,413.10 |
Molina Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $707.95 Median $5,888.44 Typical High $10,715.19 | Facility | None | $707.95 | $5,888.44 | $10,715.19 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,412.54 | Professional | None | $776.25 | $912.01 | $1,412.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
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 $660.69 Median $870.96 Typical High $1,445.44 | Professional | None | $660.69 | $870.96 | $1,445.44 |
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 $363.08 Median $389.05 Typical High $426.58 | Professional | 52 · Reduced service | $363.08 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $154.88 Typical High $169.82 | Professional | 53 · Discontinued | $144.54 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $588.84 Typical High $630.96 | Professional | 54 · Surgery only | $537.03 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $117.49 Typical High $125.89 | Professional | 55 · Aftercare only | $109.65 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $77.62 Typical High $85.11 | Professional | 56 · Pre-op care only | $72.44 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $549.54 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $501.19 | $549.54 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,258.93 Typical High $2,238.72 | Professional | 50 · Both sides | $977.24 | $1,258.93 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $537.03 Typical High $933.25 | Professional | 62 · Two surgeons | $416.87 | $537.03 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $134.90 Typical High $239.88 | Professional | 80 · Assistant surgeon | $104.71 | $134.90 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $117.49 Typical High $208.93 | Professional | AS · PA/NP assist | $91.20 | $117.49 | $208.93 |
Where California sits
The same service costs 8.1 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· 34th of 51
$1,000
AK $3,631TX $447
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.