How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,072 to $11,220Professionalmedian $2,089 · 10th to 90th $1,514 to $12,303
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 $1,905.46 Median $6,165.95 Typical High $15,848.93 | Facility | None | $1,905.46 | $6,165.95 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,621.81 | $1,621.81 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $6,606.93 Typical High $13,489.63 | Facility | None | $2,951.21 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $2,089.30 Typical High $6,918.31 | Professional | None | $1,548.82 | $2,089.30 | $6,918.31 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,511.89 Typical High $7,943.28 | Facility | None | $100.00 | $2,511.89 | $7,943.28 |
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 $1,548.82 Median $2,238.72 Typical High $2,344.23 | Professional | None | $1,548.82 | $2,238.72 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $4,466.84 Typical High $8,912.51 | Facility | None | $575.44 | $4,466.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $4,897.79 | Professional | None | $1,659.59 | $1,905.46 | $4,897.79 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,995.26 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $4,073.80 | Professional | None | $1,698.24 | $2,089.30 | $4,073.80 |
Lucent Health Setting Professional Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $13,803.84 | Professional | None | $12,302.69 | $12,302.69 | $13,803.84 |
Molina Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $4,073.80 Typical High $8,511.38 | Facility | None | $616.60 | $4,073.80 | $8,511.38 |
Providence Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $4,786.30 | Professional | None | $1,659.59 | $1,862.09 | $4,786.30 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
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 $1,318.26 Median $1,819.70 Typical High $5,248.07 | Professional | None | $1,318.26 | $1,819.70 | $5,248.07 |
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 $812.83 Median $812.83 Typical High $891.25 | Professional | 52 · Reduced service | $812.83 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $354.81 | Professional | 53 · Discontinued | $323.59 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $269.15 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $177.83 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,071.52 Typical High $2,570.40 | Professional | 62 · Two surgeons | $891.25 | $1,071.52 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $269.15 Typical High $660.69 | Professional | 80 · Assistant surgeon | $223.87 | $269.15 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $239.88 Typical High $575.44 | Professional | AS · PA/NP assist | $199.53 | $239.88 | $575.44 |
Where California sits
The same service costs 7.1 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· 27th of 51
$2,291
AK $7,079TX $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.