How much rates vary
Facilitymedian $5,495 · 10th to 90th $631 to $56,234Professionalmedian $1,288 · 10th to 90th $1,047 to $9,333
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 $1,288.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,288.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,174.90 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $9,549.93 Typical High $19,498.45 | Facility | None | $5,495.41 | $9,549.93 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,288.25 | $2,238.72 |
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 $831.76 Median $1,174.90 Typical High $1,445.44 | Professional | None | $831.76 | $1,174.90 | $1,445.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $10,000.00 | Facility | None | $660.69 | $1,412.54 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,122.02 | $1,288.25 | $1,995.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $707.95 Median $1,318.26 Typical High $1,445.44 | Professional | None | $707.95 | $1,318.26 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,258.93 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $9,332.54 Median $10,715.19 Typical High $10,715.19 | Professional | None | $9,332.54 | $10,715.19 | $10,715.19 |
Molina Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
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 $1,122.02 Median $1,288.25 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,288.25 | $1,905.46 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Professional | None | $4,168.69 | $4,168.69 | $4,168.69 |
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 $1,023.29 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,023.29 | $1,288.25 | $1,995.26 |
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 $549.54 Median $575.44 Typical High $645.65 | Professional | 52 · Reduced service | $549.54 | $575.44 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $234.42 Typical High $257.04 | Professional | 53 · Discontinued | $218.78 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $870.96 Typical High $977.24 | Professional | 54 · Surgery only | $831.76 | $870.96 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $173.78 Typical High $194.98 | Professional | 55 · Aftercare only | $165.96 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $117.49 Typical High $128.82 | Professional | 56 · Pre-op care only | $109.65 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $812.83 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $776.25 | $812.83 | $912.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $812.83 Typical High $1,412.54 | Professional | 62 · Two surgeons | $660.69 | $812.83 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $204.17 Typical High $363.08 | Professional | 80 · Assistant surgeon | $165.96 | $204.17 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $181.97 Typical High $354.81 | Professional | AS · PA/NP assist | $144.54 | $181.97 | $354.81 |
Where California sits
The same service costs 5.4 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· 42nd of 51
$1,288
AK $4,571TX $851
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.