How much rates vary
Facilitymedian $5,370 · 10th to 90th $631 to $50,119Professionalmedian $2,138 · 10th to 90th $1,778 to $16,218
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 $2,137.96 Median $8,128.31 Typical High $19,054.61 | Facility | None | $2,137.96 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,905.46 Typical High $2,187.76 | Professional | None | $1,819.70 | $1,905.46 | $2,187.76 |
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 $2,041.74 Median $2,089.30 Typical High $3,630.78 | Professional | None | $2,041.74 | $2,089.30 | $3,630.78 |
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 $1,380.38 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,380.38 | $1,949.84 | $2,398.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,258.93 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,258.93 | $2,691.53 | $2,691.53 |
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 $1,862.09 Median $2,041.74 Typical High $3,467.37 | Professional | None | $1,862.09 | $2,041.74 | $3,467.37 |
Contra Costa Health Setting Professional Modifier None Typical Low $851.14 Median $2,398.83 Typical High $2,630.27 | Professional | None | $851.14 | $2,398.83 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $4,677.35 | Professional | None | $2,041.74 | $2,238.72 | $4,677.35 |
Lucent Health Setting Professional Modifier None Typical Low $16,218.10 Median $19,054.61 Typical High $19,054.61 | Professional | None | $16,218.10 | $19,054.61 | $19,054.61 |
Molina Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
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 $1,862.09 Median $2,041.74 Typical High $3,311.31 | Professional | None | $1,862.09 | $2,041.74 | $3,311.31 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Professional | None | $7,244.36 | $7,244.36 | $7,244.36 |
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 $1,737.80 Median $2,137.96 Typical High $3,548.13 | Professional | None | $1,737.80 | $2,137.96 | $3,548.13 |
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 $912.01 Median $954.99 Typical High $1,071.52 | Professional | 52 · Reduced service | $912.01 | $954.99 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $380.19 Typical High $436.52 | Professional | 53 · Discontinued | $363.08 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,412.54 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,348.96 | $1,412.54 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $281.84 Typical High $323.59 | Professional | 55 · Aftercare only | $269.15 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $190.55 Typical High $213.80 | Professional | 56 · Pre-op care only | $181.97 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,318.26 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,318.26 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,412.54 Typical High $2,630.27 | Professional | 62 · Two surgeons | $1,174.90 | $1,412.54 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $354.81 Typical High $660.69 | Professional | 80 · Assistant surgeon | $295.12 | $354.81 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $309.03 Typical High $588.84 | Professional | AS · PA/NP assist | $257.04 | $309.03 | $588.84 |
Where California sits
The same service costs 20.9 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· 44th of 51
$2,138
AK $7,586TX $363
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.