How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $50,119Professionalmedian $1,380 · 10th to 90th $1,122 to $11,749
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 $1,412.54 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,412.54 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,258.93 | $1,412.54 |
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 $1,230.27 Median $1,380.38 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,380.38 | $2,398.83 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $4,168.69 Typical High $8,709.64 | Facility | None | $67.61 | $4,168.69 | $8,709.64 |
Blue Shield Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $1,584.89 | Professional | None | $891.25 | $1,288.25 | $1,584.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $1,698.24 | Professional | None | $1,288.25 | $1,584.89 | $1,698.24 |
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 $1,230.27 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,412.54 | $2,187.76 |
Contra Costa Health Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $1,548.82 | Professional | None | $954.99 | $1,412.54 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,348.96 | $2,754.23 |
Lucent Health Setting Professional Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $12,302.69 | Professional | None | $11,748.98 | $11,748.98 | $12,302.69 |
Molina Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $1,230.27 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,230.27 | $1,412.54 | $2,041.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
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 $1,122.02 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,380.38 | $2,137.96 |
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 $588.84 Median $630.96 Typical High $691.83 | Professional | 52 · Reduced service | $588.84 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $251.19 Typical High $281.84 | Professional | 53 · Discontinued | $239.88 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $933.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $891.25 | $933.25 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $208.93 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $125.89 Typical High $141.25 | Professional | 56 · Pre-op care only | $120.23 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $870.96 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $831.76 | $870.96 | $977.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $870.96 Typical High $1,698.24 | Professional | 62 · Two surgeons | $724.44 | $870.96 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $223.87 Typical High $436.52 | Professional | 80 · Assistant surgeon | $186.21 | $223.87 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $194.98 Typical High $380.19 | Professional | AS · PA/NP assist | $162.18 | $194.98 | $380.19 |
Where California sits
The same service costs 5.2 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
$1,380
AK $4,898TX $933
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.