How much rates vary
Facilitymedian $6,761 · 10th to 90th $631 to $50,119Professionalmedian $4,677 · 10th to 90th $2,188 to $30,903
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 $4,168.69 Median $8,128.31 Typical High $19,054.61 | Facility | None | $4,168.69 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $4,168.69 Typical High $4,570.88 | Professional | None | $3,981.07 | $4,168.69 | $4,570.88 |
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 $3,890.45 Median $4,677.35 Typical High $7,413.10 | Professional | None | $3,890.45 | $4,677.35 | $7,413.10 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $4,786.30 Typical High $10,000.00 | Facility | None | $67.61 | $4,786.30 | $10,000.00 |
Blue Shield Setting Professional Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,445.44 | $2,041.74 | $2,511.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,884.03 Median $4,897.79 Typical High $4,897.79 | Professional | None | $2,884.03 | $4,897.79 | $4,897.79 |
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 $3,630.78 Median $4,570.88 Typical High $6,760.83 | Professional | None | $3,630.78 | $4,570.88 | $6,760.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,949.84 Median $4,365.16 Typical High $4,786.30 | Professional | None | $1,949.84 | $4,365.16 | $4,786.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,801.89 Median $4,168.69 Typical High $8,511.38 | Professional | None | $3,801.89 | $4,168.69 | $8,511.38 |
Lucent Health Setting Professional Modifier None Typical Low $30,902.95 Median $36,307.81 Typical High $36,307.81 | Professional | None | $30,902.95 | $36,307.81 | $36,307.81 |
Molina Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,606.93 | $6,606.93 | $6,606.93 |
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 $3,630.78 Median $4,466.84 Typical High $6,456.54 | Professional | None | $3,630.78 | $4,466.84 | $6,456.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $14,125.38 | Professional | None | $14,125.38 | $14,125.38 | $14,125.38 |
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 $3,467.37 Median $4,265.80 Typical High $6,918.31 | Professional | None | $3,467.37 | $4,265.80 | $6,918.31 |
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 $1,995.26 Median $2,089.30 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,995.26 | $2,089.30 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $831.76 Typical High $933.25 | Professional | 53 · Discontinued | $794.33 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $3,162.28 Typical High $3,467.37 | Professional | 54 · Surgery only | $2,951.21 | $3,162.28 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $630.96 Typical High $691.83 | Professional | 55 · Aftercare only | $588.84 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $416.87 Typical High $457.09 | Professional | 56 · Pre-op care only | $398.11 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $2,951.21 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $2,754.23 | $2,951.21 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,949.84 Median $2,691.53 Typical High $4,897.79 | Professional | 62 · Two surgeons | $1,949.84 | $2,691.53 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $691.83 Typical High $1,258.93 | Professional | 80 · Assistant surgeon | $501.19 | $691.83 | $1,258.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $436.52 Median $602.56 Typical High $1,096.48 | Professional | AS · PA/NP assist | $436.52 | $602.56 | $1,096.48 |
Where California sits
The same service costs 21.9 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· 35th of 51
$4,677
AK $15,136TX $692
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.