How much rates vary
Facilitymedian $4,467 · 10th to 90th $617 to $151,356Professionalmedian $1,479 · 10th to 90th $1,047 to $8,511
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 $1,174.90 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,174.90 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,096.48 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,715.19 Typical High $19,498.45 | Facility | None | $5,248.07 | $10,715.19 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $4,786.30 | Professional | None | $1,380.38 | $1,548.82 | $4,786.30 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,606.93 | Facility | None | $67.61 | $3,090.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $3,235.94 | Professional | None | $954.99 | $1,348.96 | $3,235.94 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,412.54 | Professional | None | $758.58 | $1,148.15 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $10,000.00 | Facility | None | $660.69 | $1,412.54 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $3,311.31 | Professional | None | $1,148.15 | $1,318.26 | $3,311.31 |
Contra Costa Health Setting Professional Modifier None Typical Low $602.56 Median $1,258.93 Typical High $1,513.56 | Professional | None | $602.56 | $1,258.93 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,818.38 | Professional | None | $1,148.15 | $1,445.44 | $2,818.38 |
Lucent Health Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $10,232.93 | Professional | None | $8,511.38 | $8,511.38 | $10,232.93 |
Molina Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $1,148.15 Median $1,288.25 Typical High $3,311.31 | Professional | None | $1,148.15 | $1,288.25 | $3,311.31 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
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 $977.24 Median $1,288.25 Typical High $3,548.13 | Professional | None | $977.24 | $1,288.25 | $3,548.13 |
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 $549.54 Median $549.54 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $245.47 | Professional | 53 · Discontinued | $223.87 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $870.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $794.33 Typical High $1,862.09 | Professional | 62 · Two surgeons | $630.96 | $794.33 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $204.17 Typical High $467.74 | Professional | 80 · Assistant surgeon | $162.18 | $204.17 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $181.97 Typical High $416.87 | Professional | AS · PA/NP assist | $141.25 | $181.97 | $416.87 |
Where California sits
The same service costs 6.8 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· 32nd of 51
$1,549
AK $4,898TX $724
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.