How much rates vary
Facilitymedian $5,495 · 10th to 90th $631 to $56,234Professionalmedian $1,698 · 10th to 90th $1,380 to $12,023
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 $1,698.24 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,698.24 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $1,698.24 | Professional | None | $1,445.44 | $1,513.56 | $1,698.24 |
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 $1,548.82 Median $1,698.24 Typical High $2,951.21 | Professional | None | $1,548.82 | $1,698.24 | $2,951.21 |
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 $1,122.02 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,122.02 | $1,621.81 | $1,995.26 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,862.09 | $1,862.09 |
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 $1,513.56 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,513.56 | $1,698.24 | $2,630.27 |
Contra Costa Health Setting Professional Modifier None Typical Low $977.24 Median $1,698.24 Typical High $1,862.09 | Professional | None | $977.24 | $1,698.24 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $3,388.44 | Professional | None | $1,445.44 | $1,621.81 | $3,388.44 |
Lucent Health Setting Professional Modifier None Typical Low $12,022.64 Median $13,803.84 Typical High $13,803.84 | Professional | None | $12,022.64 | $13,803.84 | $13,803.84 |
Molina Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
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 $1,513.56 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,513.56 | $1,698.24 | $2,511.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,495.41 | $5,495.41 | $5,495.41 |
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 $1,348.96 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,698.24 | $2,630.27 |
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 $724.44 Median $758.58 Typical High $851.14 | Professional | 52 · Reduced service | $724.44 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $338.84 | Professional | 53 · Discontinued | $288.40 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,148.15 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,071.52 | $1,148.15 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $229.09 Typical High $251.19 | Professional | 55 · Aftercare only | $218.78 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $169.82 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,071.52 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,071.52 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,047.13 Typical High $2,089.30 | Professional | 62 · Two surgeons | $870.96 | $1,047.13 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $269.15 Typical High $524.81 | Professional | 80 · Assistant surgeon | $223.87 | $269.15 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $234.42 Typical High $457.09 | Professional | AS · PA/NP assist | $194.98 | $234.42 | $457.09 |
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
$1,698
AK $5,888TX $1,096
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.