How much rates vary
Facilitymedian $4,786 · 10th to 90th $631 to $50,119Professionalmedian $1,622 · 10th to 90th $1,318 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 $1,621.81 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,621.81 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $1,621.81 | Professional | None | $1,380.38 | $1,479.11 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $8,317.64 Typical High $17,782.79 | Facility | None | $4,265.80 | $8,317.64 | $17,782.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,513.56 | $1,621.81 | $2,754.23 |
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 $1,023.29 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,479.11 | $1,819.70 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,548.82 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,348.96 Typical High $10,000.00 | Facility | None | $660.69 | $1,348.96 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,412.54 | $1,621.81 | $2,570.40 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,698.24 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $3,311.31 | Professional | None | $1,445.44 | $1,621.81 | $3,311.31 |
Lucent Health Setting Professional Modifier None Typical Low $11,748.98 Median $13,803.84 Typical High $13,803.84 | Professional | None | $11,748.98 | $13,803.84 | $13,803.84 |
Molina Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $812.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $812.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,412.54 | $1,621.81 | $2,398.83 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
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 $1,318.26 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,621.81 | $2,570.40 |
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 $691.83 Median $724.44 Typical High $812.83 | Professional | 52 · Reduced service | $691.83 | $724.44 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $295.12 Typical High $331.13 | Professional | 53 · Discontinued | $275.42 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,096.48 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,047.13 | $1,096.48 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $218.78 Typical High $245.47 | Professional | 55 · Aftercare only | $208.93 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $147.91 Typical High $162.18 | Professional | 56 · Pre-op care only | $138.04 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,023.29 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $977.24 | $1,023.29 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,023.29 Typical High $1,819.70 | Professional | 62 · Two surgeons | $831.76 | $1,023.29 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $257.04 Typical High $457.09 | Professional | 80 · Assistant surgeon | $208.93 | $257.04 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $229.09 Typical High $398.11 | Professional | AS · PA/NP assist | $186.21 | $229.09 | $398.11 |
Where California sits
The same service costs 20.4 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
$1,622
AK $5,495TX $269
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.