How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,122 to $47,863Professionalmedian $1,259 · 10th to 90th $1,023 to $3,981
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 $1,258.93 Median $9,772.37 Typical High $19,952.62 | Facility | None | $1,258.93 | $9,772.37 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,258.93 | Professional | None | $1,071.52 | $1,148.15 | $1,258.93 |
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 $1,258.93 Median $1,258.93 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,258.93 | $2,187.76 |
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 $812.83 Median $1,148.15 Typical High $1,412.54 | Professional | None | $812.83 | $1,148.15 | $1,412.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,174.90 | $1,445.44 | $1,445.44 |
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 $1,258.93 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,258.93 | $1,949.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $794.33 Median $1,288.25 Typical High $1,445.44 | Professional | None | $794.33 | $1,288.25 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $2,691.53 | Professional | None | $1,122.02 | $1,230.27 | $2,691.53 |
Lucent Health Setting Professional Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Professional | None | $12,302.69 | $12,302.69 | $12,302.69 |
Molina Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $1,096.48 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,096.48 | $1,258.93 | $1,862.09 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,370.32 Typical High $16,982.44 | Facility | None | $2,290.87 | $5,370.32 | $16,982.44 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,258.93 | $1,949.84 |
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 $537.03 Median $562.34 Typical High $630.96 | Professional | 52 · Reduced service | $537.03 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $229.09 Typical High $251.19 | Professional | 53 · Discontinued | $213.80 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $851.14 Typical High $954.99 | Professional | 54 · Surgery only | $812.83 | $851.14 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $169.82 Typical High $190.55 | Professional | 55 · Aftercare only | $162.18 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $114.82 Typical High $125.89 | Professional | 56 · Pre-op care only | $107.15 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $794.33 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $758.58 | $794.33 | $891.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $812.83 Typical High $1,380.38 | Professional | 62 · Two surgeons | $660.69 | $812.83 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $208.93 Typical High $389.05 | Professional | 80 · Assistant surgeon | $165.96 | $208.93 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $181.97 Typical High $346.74 | Professional | AS · PA/NP assist | $147.91 | $181.97 | $346.74 |
Where California sits
The same service costs 26.3 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· 41st of 51
$1,259
AK $5,248TX $200
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.