How much rates vary
Facilitymedian $5,129 · 10th to 90th $631 to $47,863Professionalmedian $3,715 · 10th to 90th $3,020 to $29,512
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 $3,311.31 Median $8,128.31 Typical High $19,054.61 | Facility | None | $3,311.31 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,311.31 Typical High $3,715.35 | Professional | None | $3,162.28 | $3,311.31 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $6,165.95 Typical High $13,489.63 | Facility | None | $3,801.89 | $6,165.95 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,235.94 Median $3,715.35 Typical High $6,456.54 | Professional | None | $3,235.94 | $3,715.35 | $6,456.54 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $7,762.47 Typical High $16,218.10 | Facility | None | $67.61 | $7,762.47 | $16,218.10 |
Blue Shield Setting Professional Modifier None Typical Low $2,511.89 Median $3,630.78 Typical High $4,466.84 | Professional | None | $2,511.89 | $3,630.78 | $4,466.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,630.27 Median $4,365.16 Typical High $4,365.16 | Professional | None | $2,630.27 | $4,365.16 | $4,365.16 |
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 $3,311.31 Median $3,630.78 Typical High $6,025.60 | Professional | None | $3,311.31 | $3,630.78 | $6,025.60 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,778.28 Median $3,890.45 Typical High $4,265.80 | Professional | None | $1,778.28 | $3,890.45 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $7,585.78 | Professional | None | $3,311.31 | $3,715.35 | $7,585.78 |
Lucent Health Setting Professional Modifier None Typical Low $29,512.09 Median $31,622.78 Typical High $31,622.78 | Professional | None | $29,512.09 | $31,622.78 | $31,622.78 |
Molina Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
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 $3,311.31 Median $3,630.78 Typical High $5,623.41 | Professional | None | $3,311.31 | $3,630.78 | $5,623.41 |
Sutter Health Plus Setting Professional Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Professional | None | $12,302.69 | $12,302.69 | $12,302.69 |
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 $3,019.95 Median $3,715.35 Typical High $5,888.44 | Professional | None | $3,019.95 | $3,715.35 | $5,888.44 |
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 $1,584.89 Median $1,621.81 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,584.89 | $1,621.81 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $660.69 Typical High $741.31 | Professional | 53 · Discontinued | $630.96 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,454.71 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,344.23 | $2,454.71 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $489.78 Typical High $562.34 | Professional | 55 · Aftercare only | $467.74 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $331.13 Typical High $371.54 | Professional | 56 · Pre-op care only | $316.23 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,290.87 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,290.87 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,862.09 Median $2,344.23 Typical High $4,365.16 | Professional | 62 · Two surgeons | $1,862.09 | $2,344.23 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $478.63 Median $588.84 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $478.63 | $588.84 | $1,096.48 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $416.87 Median $524.81 Typical High $954.99 | Professional | AS · PA/NP assist | $416.87 | $524.81 | $954.99 |
Where California sits
The same service costs 21.9 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· 42nd of 51
$3,715
AK $13,183TX $603
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.