How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,259 to $15,488Professionalmedian $1,738 · 10th to 90th $1,288 to $12,303
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 $1,412.54 Typical High $2,238.72 | Professional | None | $1,348.96 | $1,412.54 | $2,238.72 |
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 $1,698.24 Median $1,778.28 Typical High $3,890.45 | Professional | None | $1,698.24 | $1,778.28 | $3,890.45 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $2,089.30 Typical High $9,332.54 | Facility | None | $91.20 | $2,089.30 | $9,332.54 |
Blue Shield Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $1,949.84 | Professional | None | $954.99 | $1,412.54 | $1,949.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,778.28 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $6,918.31 Typical High $11,481.54 | Facility | None | $794.33 | $6,918.31 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,380.38 | $1,584.89 | $2,511.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,584.89 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $4,265.80 | Professional | None | $1,348.96 | $1,698.24 | $4,265.80 |
Lucent Health Setting Professional Modifier None Typical Low $12,302.69 Median $15,135.61 Typical High $15,135.61 | Professional | None | $12,302.69 | $15,135.61 | $15,135.61 |
Molina Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
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 $6,456.54 Typical High $10,964.78 | Facility | None | $851.14 | $6,456.54 | $10,964.78 |
Providence Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,584.89 | $2,454.71 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
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 $1,230.27 Median $1,513.56 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,513.56 | $2,570.40 |
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 $676.08 Median $707.95 Typical High $758.58 | Professional | 52 · Reduced service | $676.08 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $281.84 Typical High $302.00 | Professional | 53 · Discontinued | $269.15 | $281.84 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,071.52 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,000.00 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $223.87 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $151.36 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,000.00 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $933.25 | $1,000.00 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,511.89 Typical High $4,168.69 | Professional | 50 · Both sides | $1,949.84 | $2,511.89 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,047.13 Typical High $1,737.80 | Professional | 62 · Two surgeons | $831.76 | $1,047.13 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $263.03 Typical High $436.52 | Professional | 80 · Assistant surgeon | $208.93 | $263.03 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $234.42 Typical High $389.05 | Professional | AS · PA/NP assist | $181.97 | $234.42 | $389.05 |
Where California sits
The same service costs 8.9 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· 37th of 51
$1,778
AK $6,457TX $724
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.