How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $56,234Professionalmedian $1,072 · 10th to 90th $832 to $7,079
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 $1,047.13 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,047.13 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,047.13 | Professional | None | $891.25 | $933.25 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $12,589.25 Typical High $26,302.68 | Facility | None | $7,244.36 | $12,589.25 | $26,302.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,071.52 | $1,905.46 |
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 $741.31 Median $1,047.13 Typical High $1,318.26 | Professional | None | $741.31 | $1,047.13 | $1,318.26 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,174.90 | $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 $954.99 Median $1,047.13 Typical High $1,513.56 | Professional | None | $954.99 | $1,047.13 | $1,513.56 |
Contra Costa Health Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,148.15 | Professional | None | $794.33 | $1,047.13 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $2,041.74 | Professional | None | $891.25 | $1,000.00 | $2,041.74 |
Lucent Health Setting Professional Modifier None Typical Low $7,079.46 Median $8,511.38 Typical High $8,511.38 | Professional | None | $7,079.46 | $8,511.38 | $8,511.38 |
Molina Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
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 $954.99 Median $1,047.13 Typical High $1,513.56 | Professional | None | $954.99 | $1,047.13 | $1,513.56 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
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 $794.33 Median $1,023.29 Typical High $1,548.82 | Professional | None | $794.33 | $1,023.29 | $1,548.82 |
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 $446.68 Median $467.74 Typical High $524.81 | Professional | 52 · Reduced service | $446.68 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $208.93 | Professional | 53 · Discontinued | $177.83 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $776.25 | Professional | 54 · Surgery only | $660.69 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $154.88 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $93.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $89.13 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $724.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $645.65 Typical High $1,230.27 | Professional | 62 · Two surgeons | $512.86 | $645.65 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $162.18 Typical High $323.59 | Professional | 80 · Assistant surgeon | $131.83 | $162.18 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $141.25 Typical High $275.42 | Professional | AS · PA/NP assist | $114.82 | $141.25 | $275.42 |
Where California sits
The same service costs 24.5 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· 36th of 51
$1,072
AK $4,074TX $166
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.