How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,175 to $12,023Professionalmedian $1,585 · 10th to 90th $1,175 to $10,000
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 $1,174.90 Median $1,258.93 Typical High $1,348.96 | Professional | None | $1,174.90 | $1,258.93 | $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 $1,479.11 Median $1,584.89 Typical High $3,630.78 | Professional | None | $1,479.11 | $1,584.89 | $3,630.78 |
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 $1,047.13 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,548.82 | $2,187.76 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,737.80 | $2,290.87 |
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 $1,288.25 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,445.44 | $2,238.72 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,548.82 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $3,235.94 | Professional | None | $1,258.93 | $1,621.81 | $3,235.94 |
Lucent Health Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $11,481.54 | Professional | None | $10,000.00 | $10,000.00 | $11,481.54 |
Molina Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $4,897.79 Typical High $8,912.51 | Facility | None | $758.58 | $4,897.79 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,445.44 | $2,238.72 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
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 $1,071.52 Median $1,348.96 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,348.96 | $2,290.87 |
8 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 $588.84 Median $630.96 Typical High $676.08 | Professional | 52 · Reduced service | $588.84 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $251.19 Typical High $269.15 | Professional | 53 · Discontinued | $234.42 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $954.99 Typical High $1,023.29 | Professional | 54 · Surgery only | $891.25 | $954.99 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $204.17 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $125.89 Typical High $134.90 | Professional | 56 · Pre-op care only | $117.49 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $891.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $831.76 | $891.25 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $218.78 Typical High $398.11 | Professional | 80 · Assistant surgeon | $169.82 | $218.78 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $194.98 Typical High $323.59 | Professional | AS · PA/NP assist | $151.36 | $194.98 | $323.59 |
Where California sits
The same service costs 17.0 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
$1,622
AK $5,623TX $331
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.