How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,349 to $12,303Professionalmedian $1,778 · 10th to 90th $1,288 to $11,220
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 $7,585.78 Typical High $18,197.01 | Facility | None | $2,238.72 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,412.54 Typical High $1,513.56 | Professional | None | $1,348.96 | $1,412.54 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,232.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $4,073.80 | Professional | None | $1,659.59 | $1,778.28 | $4,073.80 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $2,511.89 Typical High $7,762.47 | Facility | None | $91.20 | $2,511.89 | $7,762.47 |
Blue Shield Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,621.81 | $2,238.72 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,445.44 | $1,778.28 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,162.28 Typical High $5,623.41 | Facility | None | $794.33 | $3,162.28 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,621.81 | $2,454.71 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,584.89 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $3,548.13 | Professional | None | $1,318.26 | $1,698.24 | $3,548.13 |
Lucent Health Setting Professional Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $12,022.64 | Professional | None | $11,220.18 | $11,220.18 | $12,022.64 |
Molina Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
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 $870.96 Median $3,019.95 Typical High $5,623.41 | Facility | None | $870.96 | $3,019.95 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,445.44 | $1,548.82 | $2,398.83 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
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 $1,202.26 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,513.56 | $2,511.89 |
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 $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 $1,905.46 Median $2,454.71 Typical High $4,073.80 | Professional | 50 · Both sides | $1,905.46 | $2,454.71 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $257.04 Typical High $426.58 | Professional | 80 · Assistant surgeon | $204.17 | $257.04 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $229.09 Typical High $380.19 | Professional | AS · PA/NP assist | $177.83 | $229.09 | $380.19 |
Where California sits
The same service costs 16.2 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
$1,778
AK $6,310TX $389
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.