How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,259 to $14,125Professionalmedian $1,479 · 10th to 90th $1,096 to $9,333
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 $1,122.02 Median $1,122.02 Typical High $4,073.80 | Professional | None | $1,122.02 | $1,122.02 | $4,073.80 |
Ambetter Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $11,481.54 Typical High $20,417.38 | Facility | None | $5,888.44 | $11,481.54 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $4,786.30 | Professional | None | $1,258.93 | $1,479.11 | $4,786.30 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,570.40 Typical High $10,964.78 | Facility | None | $100.00 | $2,570.40 | $10,964.78 |
Blue Shield Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $3,162.28 | Professional | None | $912.01 | $1,288.25 | $3,162.28 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,548.82 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,466.84 Typical High $8,912.51 | Facility | None | $851.14 | $4,466.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $3,548.13 | Professional | None | $1,174.90 | $1,348.96 | $3,548.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $851.14 Median $1,412.54 Typical High $1,698.24 | Professional | None | $851.14 | $1,412.54 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,951.21 | Professional | None | $1,202.26 | $1,513.56 | $2,951.21 |
Lucent Health Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $10,000.00 | Professional | None | $9,332.54 | $9,332.54 | $10,000.00 |
Molina Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $4,265.80 Typical High $10,000.00 | Facility | None | $912.01 | $4,265.80 | $10,000.00 |
Providence Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $3,467.37 | Professional | None | $1,174.90 | $1,348.96 | $3,467.37 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Professional | None | $4,168.69 | $4,168.69 | $4,168.69 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,754.40 | $17,378.01 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $3,801.89 | Professional | None | $977.24 | $1,348.96 | $3,801.89 |
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 $562.34 Median $562.34 Typical High $645.65 | Professional | 52 · Reduced service | $562.34 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $257.04 | Professional | 53 · Discontinued | $229.09 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $977.24 | Professional | 54 · Surgery only | $851.14 | $851.14 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $128.82 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $912.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $776.25 Typical High $1,862.09 | Professional | 62 · Two surgeons | $630.96 | $776.25 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $199.53 Typical High $467.74 | Professional | 80 · Assistant surgeon | $158.49 | $199.53 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $173.78 Typical High $407.38 | Professional | AS · PA/NP assist | $138.04 | $173.78 | $407.38 |
Where California sits
The same service costs 6.6 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· 25th of 51
$1,862
AK $5,248TX $794
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.