How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $47,863Professionalmedian $2,399 · 10th to 90th $1,995 to $17,783
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 $2,454.71 Median $8,128.31 Typical High $19,054.61 | Facility | None | $2,454.71 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $2,511.89 | Professional | None | $2,089.30 | $2,238.72 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $8,317.64 Typical High $18,197.01 | Facility | None | $4,265.80 | $8,317.64 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $4,168.69 | Professional | None | $2,398.83 | $2,398.83 | $4,168.69 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $5,888.44 Typical High $12,302.69 | Facility | None | $67.61 | $5,888.44 | $12,302.69 |
Blue Shield Setting Professional Modifier None Typical Low $1,584.89 Median $2,290.87 Typical High $2,818.38 | Professional | None | $1,584.89 | $2,290.87 | $2,818.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,187.76 | $2,884.03 | $2,884.03 |
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 $2,137.96 Median $2,290.87 Typical High $3,801.89 | Professional | None | $2,137.96 | $2,290.87 | $3,801.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,570.40 Typical High $2,818.38 | Professional | None | $1,445.44 | $2,570.40 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,454.71 Typical High $5,011.87 | Professional | None | $2,187.76 | $2,454.71 | $5,011.87 |
Lucent Health Setting Professional Modifier None Typical Low $17,782.79 Median $20,892.96 Typical High $20,892.96 | Professional | None | $17,782.79 | $20,892.96 | $20,892.96 |
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 $831.76 Median $151,356.12 Typical High $251,188.64 | Facility | None | $831.76 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $2,137.96 Median $2,290.87 Typical High $3,630.78 | Professional | None | $2,137.96 | $2,290.87 | $3,630.78 |
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 $1,905.46 Median $2,344.23 Typical High $3,801.89 | Professional | None | $1,905.46 | $2,344.23 | $3,801.89 |
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 $1,230.27 | Professional | 52 · Reduced service | $1,047.13 | $1,096.48 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $446.68 Typical High $501.19 | Professional | 53 · Discontinued | $416.87 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,659.59 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,584.89 | $1,659.59 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $331.13 Typical High $371.54 | Professional | 55 · Aftercare only | $316.23 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $223.87 Typical High $245.47 | Professional | 56 · Pre-op care only | $208.93 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,548.82 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,548.82 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,548.82 Typical High $2,884.03 | Professional | 62 · Two surgeons | $1,288.25 | $1,548.82 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $389.05 Typical High $724.44 | Professional | 80 · Assistant surgeon | $323.59 | $389.05 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $338.84 Typical High $645.65 | Professional | AS · PA/NP assist | $281.84 | $338.84 | $645.65 |
Where California sits
The same service costs 5.4 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
$2,455
AK $8,710TX $1,622
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.