How much rates vary
Facilitymedian $6,918 · 10th to 90th $631 to $56,234Professionalmedian $2,818 · 10th to 90th $2,239 to $19,498
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 $2,818.38 Median $8,128.31 Typical High $19,054.61 | Facility | None | $2,818.38 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,630.27 Typical High $3,090.30 | Professional | None | $2,511.89 | $2,630.27 | $3,090.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $11,748.98 Typical High $25,703.96 | Facility | None | $6,918.31 | $11,748.98 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,511.89 Median $2,818.38 Typical High $4,786.30 | Professional | None | $2,511.89 | $2,818.38 | $4,786.30 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $5,888.44 Typical High $12,302.69 | Facility | None | $67.61 | $5,888.44 | $12,302.69 |
Blue Shield Setting Professional Modifier None Typical Low $1,778.28 Median $2,570.40 Typical High $3,311.31 | Professional | None | $1,778.28 | $2,570.40 | $3,311.31 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,659.59 Median $3,162.28 Typical High $3,162.28 | Professional | None | $1,659.59 | $3,162.28 | $3,162.28 |
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 $2,511.89 Median $2,818.38 Typical High $4,265.80 | Professional | None | $2,511.89 | $2,818.38 | $4,265.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,096.48 Median $2,818.38 Typical High $3,090.30 | Professional | None | $1,096.48 | $2,818.38 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $2,570.40 Typical High $5,495.41 | Professional | None | $2,344.23 | $2,570.40 | $5,495.41 |
Lucent Health Setting Professional Modifier None Typical Low $19,498.45 Median $20,892.96 Typical High $20,892.96 | Professional | None | $19,498.45 | $20,892.96 | $20,892.96 |
Molina 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 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
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 $2,511.89 Median $2,818.38 Typical High $4,265.80 | Professional | None | $2,511.89 | $2,818.38 | $4,265.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
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 $2,137.96 Median $2,691.53 Typical High $4,466.84 | Professional | None | $2,137.96 | $2,691.53 | $4,466.84 |
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 $1,258.93 Median $1,318.26 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,258.93 | $1,318.26 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $524.81 Typical High $616.60 | Professional | 53 · Discontinued | $501.19 | $524.81 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,995.26 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,862.09 | $1,995.26 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $398.11 Typical High $457.09 | Professional | 55 · Aftercare only | $371.54 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $263.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $251.19 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,862.09 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,862.09 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,698.24 Typical High $3,162.28 | Professional | 62 · Two surgeons | $1,412.54 | $1,698.24 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $436.52 Typical High $794.33 | Professional | 80 · Assistant surgeon | $354.81 | $436.52 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $380.19 Typical High $707.95 | Professional | AS · PA/NP assist | $316.23 | $380.19 | $707.95 |
Where California sits
The same service costs 22.9 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· 37th of 51
$2,818
AK $9,120TX $398
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.