How much rates vary
Facilitymedian $5,754 · 10th to 90th $631 to $50,119Professionalmedian $2,399 · 10th to 90th $1,995 to $17,378
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 $2,398.83 Median $8,128.31 Typical High $19,054.61 | Facility | None | $2,398.83 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $3,467.37 | Professional | None | $2,187.76 | $2,398.83 | $3,467.37 |
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 $2,290.87 Median $2,398.83 Typical High $4,265.80 | Professional | None | $2,290.87 | $2,398.83 | $4,265.80 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $4,786.30 Typical High $10,000.00 | Facility | None | $67.61 | $4,786.30 | $10,000.00 |
Blue Shield Setting Professional Modifier None Typical Low $1,513.56 Median $2,137.96 Typical High $2,691.53 | Professional | None | $1,513.56 | $2,137.96 | $2,691.53 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,187.76 | $2,691.53 | $2,691.53 |
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 $2,137.96 Median $2,454.71 Typical High $3,801.89 | Professional | None | $2,137.96 | $2,454.71 | $3,801.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,398.83 Typical High $2,691.53 | Professional | None | $1,659.59 | $2,398.83 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $5,128.61 | Professional | None | $2,089.30 | $2,290.87 | $5,128.61 |
Lucent Health Setting Professional Modifier None Typical Low $17,378.01 Median $19,952.62 Typical High $19,952.62 | Professional | None | $17,378.01 | $19,952.62 | $19,952.62 |
Molina Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
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 $2,137.96 Median $2,454.71 Typical High $3,548.13 | Professional | None | $2,137.96 | $2,454.71 | $3,548.13 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Professional | None | $7,943.28 | $7,943.28 | $7,943.28 |
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 $1,949.84 Median $2,398.83 Typical High $3,715.35 | Professional | None | $1,949.84 | $2,398.83 | $3,715.35 |
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 $1,047.13 Median $1,096.48 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,047.13 | $1,096.48 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $436.52 Typical High $489.78 | Professional | 53 · Discontinued | $416.87 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,621.81 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,548.82 | $1,621.81 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $331.13 Typical High $363.08 | Professional | 55 · Aftercare only | $309.03 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $218.78 Typical High $239.88 | Professional | 56 · Pre-op care only | $208.93 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,513.56 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,513.56 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,584.89 Typical High $2,951.21 | Professional | 62 · Two surgeons | $1,258.93 | $1,584.89 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $398.11 Typical High $758.58 | Professional | 80 · Assistant surgeon | $323.59 | $398.11 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $346.74 Typical High $660.69 | Professional | AS · PA/NP assist | $281.84 | $346.74 | $660.69 |
Where California sits
The same service costs 21.4 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· 41st of 51
$2,399
AK $8,318TX $389
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.