How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,259 to $13,183Professionalmedian $1,380 · 10th to 90th $1,023 to $4,898
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 $2,570.40 Median $8,912.51 Typical High $19,498.45 | Facility | None | $2,570.40 | $8,912.51 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $1,174.90 | Professional | None | $1,047.13 | $1,096.48 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $6,606.93 Typical High $13,489.63 | Facility | None | $2,884.03 | $6,606.93 | $13,489.63 |
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 $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 $954.99 Median $1,380.38 Typical High $1,905.46 | Professional | None | $954.99 | $1,380.38 | $1,905.46 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,318.26 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $6,456.54 Typical High $11,481.54 | Facility | None | $794.33 | $6,456.54 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,288.25 | $1,949.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,621.81 | Professional | None | $851.14 | $1,202.26 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $2,754.23 | Professional | None | $1,000.00 | $1,288.25 | $2,754.23 |
Lucent Health Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Professional | None | $10,000.00 | $10,000.00 | $10,000.00 |
Molina Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $851.14 Median $6,165.95 Typical High $10,964.78 | Facility | None | $851.14 | $6,165.95 | $10,964.78 |
Providence Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,288.25 | $1,905.46 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
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 $933.25 Median $1,202.26 Typical High $1,905.46 | Professional | None | $933.25 | $1,202.26 | $1,905.46 |
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 $524.81 Median $549.54 Typical High $588.84 | Professional | 52 · Reduced service | $524.81 | $549.54 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $218.78 Typical High $234.42 | Professional | 53 · Discontinued | $208.93 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $831.76 Typical High $870.96 | Professional | 54 · Surgery only | $776.25 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $165.96 Typical High $173.78 | Professional | 55 · Aftercare only | $154.88 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $109.65 Typical High $117.49 | Professional | 56 · Pre-op care only | $104.71 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $776.25 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $724.44 | $776.25 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,862.09 Typical High $3,090.30 | Professional | 50 · Both sides | $1,479.11 | $1,862.09 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $794.33 Typical High $1,288.25 | Professional | 62 · Two surgeons | $616.60 | $794.33 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $199.53 Typical High $331.13 | Professional | 80 · Assistant surgeon | $158.49 | $199.53 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $173.78 Typical High $288.40 | Professional | AS · PA/NP assist | $138.04 | $173.78 | $288.40 |
Where California sits
The same service costs 8.7 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
$1,413
AK $4,786TX $550
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.