How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,514 to $19,055Professionalmedian $1,862 · 10th to 90th $1,380 to $11,749
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 $2,137.96 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,137.96 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,584.89 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $13,489.63 Typical High $25,118.86 | Facility | None | $6,918.31 | $13,489.63 | $25,118.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $4,365.16 | Professional | None | $1,778.28 | $1,905.46 | $4,365.16 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,235.94 Typical High $19,498.45 | Facility | None | $100.00 | $3,235.94 | $19,498.45 |
Blue Shield Setting Professional Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,737.80 | $2,398.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,778.28 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,495.41 Typical High $11,220.18 | Facility | None | $758.58 | $5,495.41 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,548.82 | $1,698.24 | $2,630.27 |
Contra Costa Health Setting Professional Modifier None Typical Low $831.76 Median $1,698.24 Typical High $2,089.30 | Professional | None | $831.76 | $1,698.24 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $4,466.84 | Professional | None | $1,412.54 | $1,778.28 | $4,466.84 |
Lucent Health Setting Professional Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $12,882.50 | Professional | None | $11,748.98 | $11,748.98 | $12,882.50 |
Molina Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $5,248.07 Typical High $11,220.18 | Facility | None | $831.76 | $5,248.07 | $11,220.18 |
Providence Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,659.59 | $2,570.40 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $7,762.47 Typical High $18,620.87 | Facility | None | $2,884.03 | $7,762.47 | $18,620.87 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,621.81 | $2,691.53 |
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 $707.95 Median $758.58 Typical High $794.33 | Professional | 52 · Reduced service | $707.95 | $758.58 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $302.00 Typical High $316.23 | Professional | 53 · Discontinued | $281.84 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,122.02 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,071.52 | $1,122.02 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $223.87 Typical High $239.88 | Professional | 55 · Aftercare only | $213.80 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $151.36 Typical High $158.49 | Professional | 56 · Pre-op care only | $141.25 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,047.13 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $2,344.23 Typical High $4,265.80 | Professional | 50 · Both sides | $1,659.59 | $2,344.23 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $977.24 Typical High $1,819.70 | Professional | 62 · Two surgeons | $707.95 | $977.24 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $245.47 Typical High $457.09 | Professional | 80 · Assistant surgeon | $177.83 | $245.47 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $218.78 Typical High $398.11 | Professional | AS · PA/NP assist | $154.88 | $218.78 | $398.11 |
Where California sits
The same service costs 7.8 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
$1,862
AK $6,761TX $871
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.