How much rates vary
Facilitymedian $5,495 · 10th to 90th $631 to $50,119Professionalmedian $1,514 · 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 $1,513.56 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,513.56 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,288.25 | $1,348.96 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $9,332.54 Typical High $19,498.45 | Facility | None | $5,495.41 | $9,332.54 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $2,630.27 | Professional | None | $1,380.38 | $1,513.56 | $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 $1,000.00 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,412.54 | $1,737.80 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,288.25 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,348.96 Typical High $10,000.00 | Facility | None | $660.69 | $1,348.96 | $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 $851.14 Median $1,513.56 Typical High $1,659.59 | Professional | None | $851.14 | $1,513.56 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $3,019.95 | Professional | None | $1,318.26 | $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 $812.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $812.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,348.96 | $1,513.56 | $2,238.72 |
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 $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 $1,202.26 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,479.11 | $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 $645.65 Median $676.08 Typical High $758.58 | Professional | 52 · Reduced service | $645.65 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $269.15 Typical High $302.00 | Professional | 53 · Discontinued | $257.04 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,023.29 Typical High $1,122.02 | Professional | 54 · Surgery only | $954.99 | $1,023.29 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $204.17 Typical High $223.87 | Professional | 55 · Aftercare only | $194.98 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $151.36 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $954.99 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $891.25 | $954.99 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $933.25 Typical High $1,698.24 | Professional | 62 · Two surgeons | $758.58 | $933.25 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $239.88 Typical High $467.74 | Professional | 80 · Assistant surgeon | $194.98 | $239.88 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $208.93 Typical High $380.19 | Professional | AS · PA/NP assist | $169.82 | $208.93 | $380.19 |
Where California sits
The same service costs 20.9 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· 39th of 51
$1,514
AK $5,129TX $245
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.