How much rates vary
Facilitymedian $4,677 · 10th to 90th $851 to $12,023Professionalmedian $759 · 10th to 90th $550 to $5,129
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 $6,760.83 Typical High $16,218.10 | Facility | None | $2,238.72 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $660.69 | Professional | None | $575.44 | $616.60 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $8,511.38 Typical High $18,197.01 | Facility | None | $3,715.35 | $8,511.38 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,778.28 | Professional | None | $758.58 | $758.58 | $1,778.28 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,238.72 Typical High $7,943.28 | Facility | None | $100.00 | $2,238.72 | $7,943.28 |
Blue Shield Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $1,000.00 | Professional | None | $489.78 | $707.95 | $1,000.00 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $870.96 | Professional | None | $616.60 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,370.32 Typical High $9,120.11 | Facility | None | $645.65 | $5,370.32 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,148.15 | Professional | None | $630.96 | $707.95 | $1,148.15 |
Contra Costa Health Setting Professional Modifier None Typical Low $407.38 Median $776.25 Typical High $977.24 | Professional | None | $407.38 | $776.25 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,621.81 | Professional | None | $630.96 | $812.83 | $1,621.81 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,754.40 | Professional | None | $5,128.61 | $5,128.61 | $5,754.40 |
Molina Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $707.95 Median $4,897.79 Typical High $8,912.51 | Facility | None | $707.95 | $4,897.79 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,096.48 | Professional | None | $616.60 | $707.95 | $1,096.48 |
Sutter Health Plus 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 |
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 $549.54 Median $691.83 Typical High $1,148.15 | Professional | None | $549.54 | $691.83 | $1,148.15 |
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 $295.12 Median $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $295.12 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $123.03 Typical High $131.83 | Professional | 53 · Discontinued | $117.49 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $467.74 Typical High $501.19 | Professional | 54 · Surgery only | $436.52 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $93.33 Typical High $100.00 | Professional | 55 · Aftercare only | $87.10 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $61.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $58.88 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $436.52 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $407.38 | $436.52 | $467.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,096.48 Typical High $1,819.70 | Professional | 50 · Both sides | $870.96 | $1,096.48 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $457.09 Typical High $758.58 | Professional | 62 · Two surgeons | $363.08 | $457.09 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $117.49 Typical High $194.98 | Professional | 80 · Assistant surgeon | $91.20 | $117.49 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $102.33 Typical High $169.82 | Professional | AS · PA/NP assist | $81.28 | $102.33 | $169.82 |
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· 38th of 51
$776
AK $2,884TX $363
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.