How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,148 to $13,804Professionalmedian $1,096 · 10th to 90th $813 to $7,079
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 $831.76 Median $891.25 Typical High $933.25 | Professional | None | $831.76 | $891.25 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,715.19 Typical High $19,952.62 | Facility | None | $5,248.07 | $10,715.19 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,096.48 | $2,570.40 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,162.28 Typical High $10,964.78 | Facility | None | $100.00 | $3,162.28 | $10,964.78 |
Blue Shield Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $1,445.44 | Professional | None | $707.95 | $1,023.29 | $1,445.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,445.44 | Professional | None | $933.25 | $1,148.15 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,370.32 Typical High $10,715.19 | Facility | None | $758.58 | $5,370.32 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,548.82 | Professional | None | $912.01 | $1,000.00 | $1,548.82 |
Contra Costa Health Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,380.38 | Professional | None | $758.58 | $1,023.29 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $2,238.72 | Professional | None | $851.14 | $1,096.48 | $2,238.72 |
Lucent Health Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,762.47 | Professional | None | $7,079.46 | $7,079.46 | $7,762.47 |
Molina Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
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 $812.83 Median $5,011.87 Typical High $10,715.19 | Facility | None | $812.83 | $5,011.87 | $10,715.19 |
Providence Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,513.56 | Professional | None | $912.01 | $977.24 | $1,513.56 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,754.40 | $17,378.01 |
United Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,584.89 | Professional | None | $758.58 | $954.99 | $1,584.89 |
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 $416.87 Median $436.52 Typical High $467.74 | Professional | 52 · Reduced service | $416.87 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $177.83 Typical High $186.21 | Professional | 53 · Discontinued | $165.96 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $660.69 Typical High $707.95 | Professional | 54 · Surgery only | $616.60 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $89.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $83.18 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $616.60 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $575.44 | $616.60 | $660.69 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,513.56 Typical High $2,630.27 | Professional | 50 · Both sides | $1,174.90 | $1,513.56 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $630.96 Typical High $1,122.02 | Professional | 62 · Two surgeons | $501.19 | $630.96 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $162.18 Typical High $288.40 | Professional | 80 · Assistant surgeon | $125.89 | $162.18 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $141.25 Typical High $245.47 | Professional | AS · PA/NP assist | $109.65 | $141.25 | $245.47 |
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· 35th of 51
$1,096
AK $3,981TX $501
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.