How much rates vary
Facilitymedian $5,129 · 10th to 90th $617 to $151,356Professionalmedian $4,169 · 10th to 90th $2,818 to $24,547
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 $3,162.28 Median $8,128.31 Typical High $19,054.61 | Facility | None | $3,162.28 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $4,073.80 | Professional | None | $3,090.30 | $3,090.30 | $4,073.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $14,125.38 Typical High $25,118.86 | Facility | None | $7,244.36 | $14,125.38 | $25,118.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,951.21 Median $4,265.80 Typical High $12,882.50 | Professional | None | $2,951.21 | $4,265.80 | $12,882.50 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $4,168.69 Typical High $8,709.64 | Facility | None | $67.61 | $4,168.69 | $8,709.64 |
Blue Shield Setting Professional Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $7,762.47 | Professional | None | $2,187.76 | $3,162.28 | $7,762.47 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,951.21 Typical High $3,890.45 | Professional | None | $1,737.80 | $2,951.21 | $3,890.45 |
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 $3,090.30 Median $3,630.78 Typical High $9,120.11 | Professional | None | $3,090.30 | $3,630.78 | $9,120.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,380.38 Median $3,467.37 Typical High $4,168.69 | Professional | None | $1,380.38 | $3,467.37 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,162.28 Median $3,981.07 Typical High $7,762.47 | Professional | None | $3,162.28 | $3,981.07 | $7,762.47 |
Lucent Health Setting Professional Modifier None Typical Low $24,547.09 Median $24,547.09 Typical High $28,840.32 | Professional | None | $24,547.09 | $24,547.09 | $28,840.32 |
Molina Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
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 $3,090.30 Median $3,548.13 Typical High $9,332.54 | Professional | None | $3,090.30 | $3,548.13 | $9,332.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $11,220.18 | Professional | None | $11,220.18 | $11,220.18 | $11,220.18 |
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 $2,754.23 Median $3,715.35 Typical High $10,000.00 | Professional | None | $2,754.23 | $3,715.35 | $10,000.00 |
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 $1,548.82 Median $1,548.82 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,548.82 | $1,548.82 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $616.60 Typical High $707.95 | Professional | 53 · Discontinued | $616.60 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,344.23 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,344.23 | $2,344.23 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $467.74 Typical High $524.81 | Professional | 55 · Aftercare only | $467.74 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $309.03 Typical High $354.81 | Professional | 56 · Pre-op care only | $309.03 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,187.76 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,187.76 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $2,137.96 Typical High $5,248.07 | Professional | 62 · Two surgeons | $1,584.89 | $2,137.96 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $537.03 Typical High $1,348.96 | Professional | 80 · Assistant surgeon | $398.11 | $537.03 | $1,348.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $478.63 Typical High $1,174.90 | Professional | AS · PA/NP assist | $354.81 | $478.63 | $1,174.90 |
Where California sits
The same service costs 10.7 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· 23rd of 51
$4,169
AK $14,125TX $1,318
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.