How much rates vary
Facilitymedian $2,754 · 10th to 90th $60 to $11,749Professionalmedian $1,585 · 10th to 90th $1,000 to $10,965
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 $19,054.61 | Facility | None | $2,570.40 | $8,912.51 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,230.27 | $1,318.26 | $1,380.38 |
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 $1,621.81 Typical High $3,630.78 | Professional | None | $1,288.25 | $1,621.81 | $3,630.78 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $2,089.30 Typical High $9,332.54 | Facility | None | $95.50 | $2,089.30 | $9,332.54 |
Blue Shield Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,548.82 | Professional | None | $758.58 | $1,122.02 | $1,548.82 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,737.80 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,511.89 Typical High $5,128.61 | Facility | None | $794.33 | $2,511.89 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,000.00 | $1,548.82 | $2,454.71 |
Contra Costa Health Setting Professional Modifier None Typical Low $933.25 Median $1,548.82 Typical High $1,949.84 | Professional | None | $933.25 | $1,548.82 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $3,467.37 | Professional | None | $1,318.26 | $1,659.59 | $3,467.37 |
Lucent Health Setting Professional Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $12,022.64 | Professional | None | $10,964.78 | $10,964.78 | $12,022.64 |
Molina Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
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 $2,454.71 Typical High $5,011.87 | Facility | None | $851.14 | $2,454.71 | $5,011.87 |
Providence Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,000.00 | $1,548.82 | $2,398.83 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
United Setting Facility Modifier None Typical Low $60.26 Median $1,905.46 Typical High $14,125.38 | Facility | None | $60.26 | $1,905.46 | $14,125.38 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $2,511.89 | Professional | None | $1,000.00 | $1,445.44 | $2,511.89 |
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 $616.60 Median $660.69 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $275.42 | Professional | 53 · Discontinued | $245.47 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $1,023.29 | Professional | 54 · Surgery only | $933.25 | $977.24 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $208.93 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $131.83 Typical High $138.04 | Professional | 56 · Pre-op care only | $123.03 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,344.23 Typical High $3,630.78 | Professional | 50 · Both sides | $1,905.46 | $2,344.23 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,000.00 Typical High $1,513.56 | Professional | 62 · Two surgeons | $794.33 | $1,000.00 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $251.19 Typical High $380.19 | Professional | 80 · Assistant surgeon | $204.17 | $251.19 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $218.78 Typical High $338.84 | Professional | AS · PA/NP assist | $177.83 | $218.78 | $338.84 |
Where California sits
The same service costs 8.5 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
$1,585
AK $6,166TX $724
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.