How much rates vary
Facilitymedian $4,467 · 10th to 90th $661 to $30,200Professionalmedian $2,291 · 10th to 90th $1,660 to $14,125
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 $1,949.84 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,949.84 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,819.70 | $1,819.70 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,606.93 Median $11,748.98 Typical High $24,547.09 | Facility | None | $6,606.93 | $11,748.98 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $7,585.78 | Professional | None | $1,862.09 | $2,398.83 | $7,585.78 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $2,187.76 Typical High $9,332.54 | Facility | None | $95.50 | $2,187.76 | $9,332.54 |
Blue Shield Setting Professional Modifier None Typical Low $1,288.25 Median $1,862.09 Typical High $4,570.88 | Professional | None | $1,288.25 | $1,862.09 | $4,570.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,819.70 | $2,290.87 |
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 $1,862.09 Median $2,137.96 Typical High $5,248.07 | Professional | None | $1,862.09 | $2,137.96 | $5,248.07 |
Contra Costa Health Setting Professional Modifier None Typical Low $851.14 Median $2,041.74 Typical High $2,454.71 | Professional | None | $851.14 | $2,041.74 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $4,466.84 | Professional | None | $1,778.28 | $2,238.72 | $4,466.84 |
Lucent Health Setting Professional Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $14,791.08 | Professional | None | $14,125.38 | $14,125.38 | $14,791.08 |
Molina Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
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 $1,778.28 Median $2,041.74 Typical High $5,248.07 | Professional | None | $1,778.28 | $2,041.74 | $5,248.07 |
Sutter Health Plus Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Professional | None | $6,456.54 | $6,456.54 | $6,456.54 |
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 $1,513.56 Median $2,041.74 Typical High $5,754.40 | Professional | None | $1,513.56 | $2,041.74 | $5,754.40 |
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 $912.01 Median $912.01 Typical High $1,000.00 | Professional | 52 · Reduced service | $912.01 | $912.01 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $398.11 | Professional | 53 · Discontinued | $363.08 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $295.12 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $199.53 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,202.26 Typical High $2,884.03 | Professional | 62 · Two surgeons | $1,000.00 | $1,202.26 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $302.00 Typical High $741.31 | Professional | 80 · Assistant surgeon | $251.19 | $302.00 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $269.15 Typical High $645.65 | Professional | AS · PA/NP assist | $223.87 | $269.15 | $645.65 |
Where California sits
The same service costs 7.8 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· 28th of 51
$2,344
AK $7,762TX $1,000
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.