How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,660 to $15,849Professionalmedian $4,074 · 10th to 90th $3,020 to $28,184
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 $3,162.28 Median $7,585.78 Typical High $18,197.01 | Facility | None | $3,162.28 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $3,019.95 Typical High $3,235.94 | Professional | None | $2,884.03 | $3,019.95 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $11,220.18 Typical High $20,417.38 | Facility | None | $5,370.32 | $11,220.18 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,890.45 Median $3,981.07 Typical High $10,000.00 | Professional | None | $3,890.45 | $3,981.07 | $10,000.00 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $3,548.13 Typical High $14,454.40 | Facility | None | $95.50 | $3,548.13 | $14,454.40 |
Blue Shield Setting Professional Modifier None Typical Low $2,818.38 Median $4,168.69 Typical High $5,754.40 | Professional | None | $2,818.38 | $4,168.69 | $5,754.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3,548.13 Median $4,265.80 Typical High $5,370.32 | Professional | None | $3,548.13 | $4,265.80 | $5,370.32 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $3,162.28 Median $3,801.89 Typical High $6,025.60 | Professional | None | $3,162.28 | $3,801.89 | $6,025.60 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,818.38 Median $3,890.45 Typical High $5,248.07 | Professional | None | $2,818.38 | $3,890.45 | $5,248.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,235.94 Median $4,073.80 Typical High $8,511.38 | Professional | None | $3,235.94 | $4,073.80 | $8,511.38 |
Lucent Health Setting Professional Modifier None Typical Low $28,183.83 Median $28,183.83 Typical High $29,512.09 | Professional | None | $28,183.83 | $28,183.83 | $29,512.09 |
Molina Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,495.41 | $5,495.41 | $5,495.41 |
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 $831.76 Median $6,309.57 Typical High $10,964.78 | Facility | None | $831.76 | $6,309.57 | $10,964.78 |
Providence Setting Professional Modifier None Typical Low $3,162.28 Median $3,801.89 Typical High $5,888.44 | Professional | None | $3,162.28 | $3,801.89 | $5,888.44 |
Sutter Health Plus Setting Professional Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Professional | None | $12,302.69 | $12,302.69 | $12,302.69 |
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 $2,884.03 Median $3,715.35 Typical High $6,165.95 | Professional | None | $2,884.03 | $3,715.35 | $6,165.95 |
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 $1,445.44 Median $1,513.56 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,445.44 | $1,513.56 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $602.56 Typical High $645.65 | Professional | 53 · Discontinued | $575.44 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,238.72 Typical High $2,398.83 | Professional | 54 · Surgery only | $2,137.96 | $2,238.72 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $446.68 Typical High $478.63 | Professional | 55 · Aftercare only | $426.58 | $446.68 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $302.00 Typical High $323.59 | Professional | 56 · Pre-op care only | $288.40 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,089.30 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,089.30 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $4,677.35 Median $5,888.44 Typical High $9,332.54 | Professional | 50 · Both sides | $4,677.35 | $5,888.44 | $9,332.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,949.84 Median $2,511.89 Typical High $3,981.07 | Professional | 62 · Two surgeons | $1,949.84 | $2,511.89 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $630.96 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $501.19 | $630.96 | $1,000.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $436.52 Median $549.54 Typical High $870.96 | Professional | AS · PA/NP assist | $436.52 | $549.54 | $870.96 |
Where California sits
The same service costs 20.4 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
$4,074
AK $15,488TX $759
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.