How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $56,234Professionalmedian $1,514 · 10th to 90th $1,175 to $10,233
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 $1,548.82 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,548.82 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,318.26 | $1,380.38 | $1,548.82 |
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 $1,380.38 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,548.82 | $2,570.40 |
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 $1,288.25 Typical High $1,584.89 | Professional | None | $912.01 | $1,288.25 | $1,584.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $1,778.28 | Professional | None | $1,380.38 | $1,698.24 | $1,778.28 |
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 $1,318.26 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,318.26 | $1,513.56 | $2,238.72 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,513.56 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $2,951.21 | Professional | None | $1,288.25 | $1,445.44 | $2,951.21 |
Lucent Health Setting Professional Modifier None Typical Low $10,232.93 Median $12,302.69 Typical High $12,302.69 | Professional | None | $10,232.93 | $12,302.69 | $12,302.69 |
Molina Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $1,318.26 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,513.56 | $2,137.96 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
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 $1,148.15 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,479.11 | $2,238.72 |
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 $645.65 Median $691.83 Typical High $776.25 | Professional | 52 · Reduced service | $645.65 | $691.83 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $275.42 Typical High $309.03 | Professional | 53 · Discontinued | $263.03 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,023.29 Typical High $1,148.15 | Professional | 54 · Surgery only | $977.24 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $208.93 Typical High $234.42 | Professional | 55 · Aftercare only | $194.98 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $154.88 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $954.99 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $912.01 | $954.99 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $891.25 Typical High $1,737.80 | Professional | 62 · Two surgeons | $741.31 | $891.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $229.09 Typical High $446.68 | Professional | 80 · Assistant surgeon | $190.55 | $229.09 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $199.53 Typical High $389.05 | Professional | AS · PA/NP assist | $165.96 | $199.53 | $389.05 |
Where California sits
The same service costs 5.0 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
$1,514
AK $5,012TX $1,000
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.