How much rates vary
Facilitymedian $3,548 · 10th to 90th $977 to $12,589Professionalmedian $1,122 · 10th to 90th $832 to $4,074
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 $870.96 Median $912.01 Typical High $1,000.00 | Professional | None | $870.96 | $912.01 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,128.31 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,691.53 | Professional | None | $1,122.02 | $1,122.02 | $2,691.53 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $1,548.82 Typical High $6,606.93 | Facility | None | $91.20 | $1,548.82 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,513.56 | Professional | None | $741.31 | $1,096.48 | $1,513.56 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,230.27 | $1,659.59 |
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 $851.14 Median $1,047.13 Typical High $1,659.59 | Professional | None | $851.14 | $1,047.13 | $1,659.59 |
Contra Costa Health Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,479.11 | Professional | None | $870.96 | $1,096.48 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $2,398.83 | Professional | None | $912.01 | $1,174.90 | $2,398.83 |
Lucent Health Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,709.64 | $8,709.64 | $8,709.64 |
Molina Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $870.96 Median $2,454.71 Typical High $5,011.87 | Facility | None | $870.96 | $2,454.71 | $5,011.87 |
Providence Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,621.81 | Professional | None | $851.14 | $1,047.13 | $1,621.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,606.93 Typical High $18,620.87 | Facility | None | $2,884.03 | $6,606.93 | $18,620.87 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,698.24 | Professional | None | $812.83 | $1,000.00 | $1,698.24 |
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 $436.52 Median $457.09 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $181.97 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $691.83 Typical High $724.44 | Professional | 54 · Surgery only | $645.65 | $691.83 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $138.04 Typical High $144.54 | Professional | 55 · Aftercare only | $128.82 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $91.20 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $645.65 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $602.56 | $645.65 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,621.81 Typical High $2,691.53 | Professional | 50 · Both sides | $1,288.25 | $1,621.81 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $676.08 Typical High $1,122.02 | Professional | 62 · Two surgeons | $537.03 | $676.08 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $173.78 Typical High $288.40 | Professional | 80 · Assistant surgeon | $134.90 | $173.78 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $151.36 Typical High $251.19 | Professional | AS · PA/NP assist | $120.23 | $151.36 | $251.19 |
Where California sits
The same service costs 18.2 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
$1,148
AK $4,266TX $234
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.