How much rates vary
Facilitymedian $7,762 · 10th to 90th $631 to $56,234Professionalmedian $2,818 · 10th to 90th $2,138 to $17,378
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 $2,398.83 Median $8,128.31 Typical High $19,054.61 | Facility | None | $2,398.83 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,754.23 | Professional | None | $2,238.72 | $2,238.72 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $12,589.25 Typical High $26,302.68 | Facility | None | $7,244.36 | $12,589.25 | $26,302.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $3,019.95 Typical High $9,549.93 | Professional | None | $2,754.23 | $3,019.95 | $9,549.93 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $7,762.47 Typical High $16,218.10 | Facility | None | $67.61 | $7,762.47 | $16,218.10 |
Blue Shield Setting Professional Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $5,888.44 | Professional | None | $1,698.24 | $2,398.83 | $5,888.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,570.40 Typical High $2,754.23 | Professional | None | $1,819.70 | $2,570.40 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,445.44 Typical High $10,000.00 | Facility | None | $660.69 | $1,445.44 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,630.27 Typical High $6,456.54 | Professional | None | $2,290.87 | $2,630.27 | $6,456.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,454.71 Typical High $2,951.21 | Professional | None | $1,445.44 | $2,454.71 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $5,495.41 | Professional | None | $2,137.96 | $2,691.53 | $5,495.41 |
Lucent Health Setting Professional Modifier None Typical Low $17,378.01 Median $17,378.01 Typical High $18,197.01 | Professional | None | $17,378.01 | $17,378.01 | $18,197.01 |
Molina 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 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $151,356.12 Typical High $251,188.64 | Facility | None | $851.14 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $2,238.72 Median $2,570.40 Typical High $6,456.54 | Professional | None | $2,238.72 | $2,570.40 | $6,456.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Professional | None | $7,943.28 | $7,943.28 | $7,943.28 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $7,244.36 | Professional | None | $1,862.09 | $2,511.89 | $7,244.36 |
9 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 $1,122.02 Median $1,122.02 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $489.78 | Professional | 53 · Discontinued | $446.68 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $371.54 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $245.47 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,548.82 Typical High $3,548.13 | Professional | 62 · Two surgeons | $1,258.93 | $1,548.82 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $389.05 Typical High $912.01 | Professional | 80 · Assistant surgeon | $316.23 | $389.05 | $912.01 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $346.74 Typical High $794.33 | Professional | AS · PA/NP assist | $275.42 | $346.74 | $794.33 |
Where California sits
The same service costs 11.0 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· 24th of 51
$3,020
AK $9,772TX $891
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.