How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,175 to $15,488Professionalmedian $1,175 · 10th to 90th $871 to $7,413
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 $2,570.40 Median $8,912.51 Typical High $19,054.61 | Facility | None | $2,570.40 | $8,912.51 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,000.00 | Professional | None | $891.25 | $954.99 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $13,489.63 Typical High $23,442.29 | Facility | None | $6,918.31 | $13,489.63 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $2,754.23 | Professional | None | $1,071.52 | $1,174.90 | $2,754.23 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,137.96 Typical High $10,471.29 | Facility | None | $100.00 | $2,137.96 | $10,471.29 |
Blue Shield Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,513.56 | Professional | None | $741.31 | $1,096.48 | $1,513.56 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,230.27 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $7,244.36 Typical High $12,882.50 | Facility | None | $851.14 | $7,244.36 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,659.59 | Professional | None | $954.99 | $1,071.52 | $1,659.59 |
Contra Costa Health Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,479.11 | Professional | None | $933.25 | $1,174.90 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $2,398.83 | Professional | None | $912.01 | $1,174.90 | $2,398.83 |
Lucent Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $8,317.64 | Professional | None | $7,413.10 | $7,413.10 | $8,317.64 |
Molina Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $912.01 Median $6,918.31 Typical High $12,302.69 | Facility | None | $912.01 | $6,918.31 | $12,302.69 |
Providence Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,621.81 | Professional | None | $954.99 | $1,047.13 | $1,621.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 $812.83 Median $1,000.00 Typical High $1,698.24 | Professional | None | $812.83 | $1,000.00 | $1,698.24 |
9 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 $446.68 Median $478.63 Typical High $501.19 | Professional | 52 · Reduced service | $446.68 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $204.17 | Professional | 53 · Discontinued | $177.83 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $134.90 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $100.00 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,621.81 Typical High $2,818.38 | Professional | 50 · Both sides | $1,288.25 | $1,621.81 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $173.78 Typical High $288.40 | Professional | 80 · Assistant surgeon | $134.90 | $173.78 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $151.36 Typical High $251.19 | Professional | AS · PA/NP assist | $117.49 | $151.36 | $251.19 |
Where California sits
The same service costs 7.9 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
$1,175
AK $4,266TX $537
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.