How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,148 to $66,069Professionalmedian $1,585 · 10th to 90th $1,230 to $10,715
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 $1,584.89 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,584.89 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,412.54 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $10,000.00 Typical High $22,387.21 | Facility | None | $5,011.87 | $10,000.00 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,659.59 | $2,630.27 |
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 $912.01 Median $1,318.26 Typical High $1,621.81 | Professional | None | $912.01 | $1,318.26 | $1,621.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,698.24 | $1,698.24 |
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 $1,348.96 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,513.56 | $2,344.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $831.76 Median $1,513.56 Typical High $1,659.59 | Professional | None | $831.76 | $1,513.56 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,445.44 | $3,019.95 |
Lucent Health Setting Professional Modifier None Typical Low $10,715.19 Median $12,589.25 Typical High $12,589.25 | Professional | None | $10,715.19 | $12,589.25 | $12,589.25 |
Molina Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
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 $1,348.96 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,513.56 | $2,344.23 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,606.93 Typical High $18,620.87 | Facility | None | $2,884.03 | $6,606.93 | $18,620.87 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,548.82 | $2,344.23 |
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 $676.08 Median $707.95 Typical High $794.33 | Professional | 52 · Reduced service | $676.08 | $707.95 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $281.84 Typical High $323.59 | Professional | 53 · Discontinued | $269.15 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,071.52 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,000.00 | $1,071.52 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $158.49 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,000.00 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $1,000.00 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $912.01 Typical High $1,698.24 | Professional | 62 · Two surgeons | $776.25 | $912.01 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $234.42 Typical High $426.58 | Professional | 80 · Assistant surgeon | $199.53 | $234.42 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $204.17 Typical High $407.38 | Professional | AS · PA/NP assist | $173.78 | $204.17 | $407.38 |
Where California sits
The same service costs 6.3 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
$1,622
AK $6,166TX $977
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.