How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,230 to $15,488Professionalmedian $1,660 · 10th to 90th $1,259 to $11,482
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 $1,348.96 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,348.96 | $1,479.11 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $11,481.54 Typical High $21,379.62 | Facility | None | $5,370.32 | $11,481.54 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $3,801.89 | Professional | None | $1,584.89 | $1,698.24 | $3,801.89 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $2,089.30 Typical High $7,585.78 | Facility | None | $91.20 | $2,089.30 | $7,585.78 |
Blue Shield Setting Professional Modifier None Typical Low $1,047.13 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,548.82 | $2,137.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,348.96 | $1,659.59 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $6,456.54 Typical High $11,481.54 | Facility | None | $794.33 | $6,456.54 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,513.56 | $2,344.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,513.56 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $3,981.07 | Professional | None | $1,258.93 | $1,584.89 | $3,981.07 |
Lucent Health Setting Professional Modifier None Typical Low $11,481.54 Median $13,489.63 Typical High $13,489.63 | Professional | None | $11,481.54 | $13,489.63 | $13,489.63 |
Molina Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $851.14 Median $6,165.95 Typical High $10,964.78 | Facility | None | $851.14 | $6,165.95 | $10,964.78 |
Providence Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,380.38 | $1,479.11 | $2,290.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,918.31 Typical High $20,417.38 | Facility | None | $2,884.03 | $6,918.31 | $20,417.38 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,445.44 | $2,344.23 |
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 $630.96 Median $676.08 Typical High $707.95 | Professional | 52 · Reduced service | $630.96 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $269.15 Typical High $281.84 | Professional | 53 · Discontinued | $251.19 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,000.00 Typical High $1,071.52 | Professional | 54 · Surgery only | $954.99 | $1,000.00 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $199.53 Typical High $213.80 | Professional | 55 · Aftercare only | $190.55 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $134.90 Typical High $141.25 | Professional | 56 · Pre-op care only | $125.89 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $933.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $891.25 | $933.25 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,290.87 Typical High $4,073.80 | Professional | 50 · Both sides | $1,819.70 | $2,290.87 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $977.24 Typical High $1,698.24 | Professional | 62 · Two surgeons | $758.58 | $977.24 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $245.47 Typical High $426.58 | Professional | 80 · Assistant surgeon | $194.98 | $245.47 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $213.80 Typical High $380.19 | Professional | AS · PA/NP assist | $169.82 | $213.80 | $380.19 |
Where California sits
The same service costs 8.7 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
$1,660
AK $5,888TX $676
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.