How much rates vary
Facilitymedian $4,786 · 10th to 90th $631 to $50,119Professionalmedian $1,479 · 10th to 90th $1,202 to $10,965
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 $1,479.11 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,479.11 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,318.26 | $1,479.11 |
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 $1,380.38 Median $1,479.11 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,479.11 | $2,570.40 |
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 $933.25 Median $1,348.96 Typical High $1,659.59 | Professional | None | $933.25 | $1,348.96 | $1,659.59 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,778.28 | $1,778.28 |
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 $1,288.25 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,445.44 | $2,344.23 |
Contra Costa Health Setting Professional Modifier None Typical Low $851.14 Median $1,621.81 Typical High $1,778.28 | Professional | None | $851.14 | $1,621.81 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $3,162.28 | Professional | None | $1,348.96 | $1,513.56 | $3,162.28 |
Lucent Health Setting Professional Modifier None Typical Low $10,964.78 Median $12,882.50 Typical High $12,882.50 | Professional | None | $10,964.78 | $12,882.50 | $12,882.50 |
Molina Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
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 $1,288.25 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,445.44 | $2,238.72 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
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 $1,174.90 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,445.44 | $2,398.83 |
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 $630.96 Median $660.69 Typical High $741.31 | Professional | 52 · Reduced service | $630.96 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $263.03 Typical High $302.00 | Professional | 53 · Discontinued | $251.19 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,000.00 Typical High $1,122.02 | Professional | 54 · Surgery only | $933.25 | $1,000.00 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $199.53 Typical High $223.87 | Professional | 55 · Aftercare only | $186.21 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $131.83 Typical High $147.91 | Professional | 56 · Pre-op care only | $125.89 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $933.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $870.96 | $933.25 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $933.25 Typical High $1,621.81 | Professional | 62 · Two surgeons | $758.58 | $933.25 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $234.42 Typical High $416.87 | Professional | 80 · Assistant surgeon | $194.98 | $234.42 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $204.17 Typical High $363.08 | Professional | AS · PA/NP assist | $169.82 | $204.17 | $363.08 |
Where California sits
The same service costs 5.1 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
$1,479
AK $5,129TX $1,000
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.