How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,230 to $19,498Professionalmedian $1,413 · 10th to 90th $1,047 to $9,120
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 $1,071.52 Median $1,202.26 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,202.26 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,715.19 Typical High $26,302.68 | Facility | None | $5,248.07 | $10,715.19 | $26,302.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $3,090.30 | Professional | None | $1,288.25 | $1,412.54 | $3,090.30 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,162.28 Typical High $11,748.98 | Facility | None | $100.00 | $3,162.28 | $11,748.98 |
Blue Shield Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $1,737.80 | Professional | None | $851.14 | $1,258.93 | $1,737.80 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,513.56 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $14,125.38 Typical High $23,988.33 | Facility | None | $758.58 | $14,125.38 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,288.25 | $2,041.74 |
Contra Costa Health Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,819.70 | Professional | None | $954.99 | $1,348.96 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $3,548.13 | Professional | None | $1,122.02 | $1,412.54 | $3,548.13 |
Lucent Health Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $10,232.93 | Professional | None | $9,120.11 | $9,120.11 | $10,232.93 |
Molina Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $10,964.78 Typical High $20,417.38 | Facility | None | $812.83 | $10,964.78 | $20,417.38 |
Providence Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,258.93 | $1,949.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $20,892.96 | Facility | None | $2,884.03 | $6,760.83 | $20,892.96 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $2,041.74 | Professional | None | $977.24 | $1,230.27 | $2,041.74 |
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 $537.03 Median $562.34 Typical High $602.56 | Professional | 52 · Reduced service | $537.03 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $229.09 Typical High $245.47 | Professional | 53 · Discontinued | $213.80 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $851.14 Typical High $912.01 | Professional | 54 · Surgery only | $794.33 | $851.14 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $169.82 Typical High $181.97 | Professional | 55 · Aftercare only | $162.18 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $114.82 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $794.33 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $741.31 | $794.33 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,949.84 Typical High $3,235.94 | Professional | 50 · Both sides | $1,513.56 | $1,949.84 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $812.83 Typical High $1,348.96 | Professional | 62 · Two surgeons | $645.65 | $812.83 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $208.93 Typical High $338.84 | Professional | 80 · Assistant surgeon | $162.18 | $208.93 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $181.97 Typical High $302.00 | Professional | AS · PA/NP assist | $141.25 | $181.97 | $302.00 |
Where California sits
The same service costs 7.6 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
$1,413
AK $5,129TX $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.