How much rates vary
Facilitymedian $7,244 · 10th to 90th $631 to $56,234Professionalmedian $2,818 · 10th to 90th $2,291 to $20,417
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 $2,398.83 Median $2,570.40 Typical High $2,818.38 | Professional | None | $2,398.83 | $2,570.40 | $2,818.38 |
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 $2,818.38 Median $2,818.38 Typical High $5,011.87 | Professional | None | $2,818.38 | $2,818.38 | $5,011.87 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $6,760.83 Typical High $14,125.38 | Facility | None | $67.61 | $6,760.83 | $14,125.38 |
Blue Shield Setting Professional Modifier None Typical Low $1,949.84 Median $2,754.23 Typical High $3,388.44 | Professional | None | $1,949.84 | $2,754.23 | $3,388.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,691.53 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,691.53 | $3,235.94 | $3,235.94 |
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 $2,754.23 Typical High $4,168.69 | Professional | None | $2,511.89 | $2,754.23 | $4,168.69 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $3,162.28 | Professional | None | $2,187.76 | $2,884.03 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,511.89 Median $2,754.23 Typical High $6,025.60 | Professional | None | $2,511.89 | $2,754.23 | $6,025.60 |
Lucent Health Setting Professional Modifier None Typical Low $20,417.38 Median $23,988.33 Typical High $23,988.33 | Professional | None | $20,417.38 | $23,988.33 | $23,988.33 |
Molina Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
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 $2,691.53 Typical High $4,168.69 | Professional | None | $2,511.89 | $2,691.53 | $4,168.69 |
Sutter Health Plus Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,709.64 | $8,709.64 | $8,709.64 |
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 $2,754.23 Typical High $4,168.69 | Professional | None | $2,137.96 | $2,754.23 | $4,168.69 |
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 $1,202.26 Median $1,288.25 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,202.26 | $1,288.25 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $512.86 Typical High $562.34 | Professional | 53 · Discontinued | $478.63 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,905.46 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,819.70 | $1,905.46 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $380.19 Typical High $426.58 | Professional | 55 · Aftercare only | $363.08 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $257.04 Typical High $281.84 | Professional | 56 · Pre-op care only | $239.88 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,778.28 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,778.28 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,737.80 Typical High $3,467.37 | Professional | 62 · Two surgeons | $1,412.54 | $1,737.80 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $446.68 Typical High $891.25 | Professional | 80 · Assistant surgeon | $354.81 | $446.68 | $891.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $389.05 Typical High $776.25 | Professional | AS · PA/NP assist | $309.03 | $389.05 | $776.25 |
Where California sits
The same service costs 21.4 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· 40th of 51
$2,884
AK $9,772TX $457
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.