How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,202 to $18,621Professionalmedian $1,230 · 10th to 90th $912 to $9,550
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 $912.01 Median $977.24 Typical High $2,089.30 | Professional | None | $912.01 | $977.24 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,232.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,230.27 | $2,884.03 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $3,019.95 Typical High $7,943.28 | Facility | None | $95.50 | $3,019.95 | $7,943.28 |
Blue Shield Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,584.89 | Professional | None | $776.25 | $1,148.15 | $1,584.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $14,125.38 Typical High $23,442.29 | Facility | None | $758.58 | $14,125.38 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,737.80 | Professional | None | $977.24 | $1,096.48 | $1,737.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $891.25 Median $1,548.82 Typical High $1,905.46 | Professional | None | $891.25 | $1,548.82 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $4,073.80 | Professional | None | $1,288.25 | $1,621.81 | $4,073.80 |
Lucent Health Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $11,748.98 | Professional | None | $9,549.93 | $9,549.93 | $11,748.98 |
Molina Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $831.76 Median $13,182.57 Typical High $21,877.62 | Facility | None | $831.76 | $13,182.57 | $21,877.62 |
Providence Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,659.59 | Professional | None | $977.24 | $1,096.48 | $1,659.59 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $20,417.38 | Facility | None | $2,884.03 | $6,760.83 | $20,417.38 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,995.26 | Professional | None | $831.76 | $1,071.52 | $1,995.26 |
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 $457.09 Median $489.78 Typical High $512.86 | Professional | 52 · Reduced service | $457.09 | $489.78 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $208.93 | Professional | 53 · Discontinued | $181.97 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $776.25 | Professional | 54 · Surgery only | $691.83 | $724.44 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $154.88 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $102.33 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,698.24 Typical High $3,548.13 | Professional | 50 · Both sides | $1,318.26 | $1,698.24 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $707.95 Typical High $1,479.11 | Professional | 62 · Two surgeons | $549.54 | $707.95 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $177.83 Typical High $380.19 | Professional | 80 · Assistant surgeon | $141.25 | $177.83 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $158.49 Typical High $331.13 | Professional | AS · PA/NP assist | $123.03 | $158.49 | $331.13 |
Where California sits
The same service costs 6.0 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $15,585KY $2,601
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.